MEDICARE: FERNANDO LUIS SANTIAGO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	13734	PR
2	2084N0400X	Neurology Physician	ME125944	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861435026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO LUIS SANTIAGO M.D.

Provider Business Mailing Address
First Line	:	1685 LEE RD STE 210
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2235
Country	:	US
Telephone Number	:	407-303-6729
Fax Number	:	407-628-2037

Provider Business Practice Location Address
First Line	:	265 E ROLLINS ST # 6
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5502
Country	:	US
Telephone Number	:	407-303-6729
Fax Number	:	407-628-2037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	01/03/2024

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Directions to “ FERNANDO LUIS SANTIAGO M.D.” Practice Location

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