Santiago, Mario A

Santiago, Mario A is an individual health care provider with primary practice located at 1303 S Semoran Blvd , Orlando FL 32807-2915. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Santiago, Mario A can be contacted via phone (305) 534-0076.

Contact Information

Primary practice address
1303 S Semoran Blvd Orlando FL 32807-2915
Phone: (305) 534-0076
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 14652 Puerto Rico
Allopathic & Osteopathic Physicians / General Practice 208D00000X ACN648 Florida

Profile Details

NPI number 1215998976
LBN Legal business name Santiago, Mario A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Nov 16th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215998976 NPPES
Florida Other N0716 MEDICARE
Florida MEDICAID 101875500 MEDICARE

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