Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CH6113 | FL |
NPI | 1578731097 |
---|---|
Provider Name | Dr. George Gerald Santayana |
First Address | Key Largo, FL 33037 |
Second Address | Key Largo, FL 33037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 19/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U00838 | (02) | FL |