Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | ME114607 | FL |
NPI | 1124227871 |
---|---|
Provider Name | Dr. Yesenia D Santiago |
First Address | Hollywood, FL 33021-3420 |
Second Address | Hollywood, FL 33021-3420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 12/09/2014 |