Healthcare Provider Details

I. General information

NPI: 1366079519
Provider Name (Legal Business Name): VINCENT SANTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

655 W 8TH ST
JACKSONVILLE FL
32209-6511
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-0411
  • Fax: 904-244-2165
Mailing address:
  • Phone: 904-244-0411
  • Fax: 904-244-2165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME174703
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: