Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME146521 | FL |
N | 2080P0210X | Pediatric Nephrologist | ME146521 | FL |
NPI | 1356726350 |
---|---|
Provider Name | Patrice Jovita Santiago Vigilia-Abrenica |
First Address | Gainesville, FL 32610-0296 |
Second Address | Old Town, FL 32680-3997 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2015 |
Last Update Date | 18/01/2022 |