Healthcare Provider Details

I. General information

NPI: 1235240797
Provider Name (Legal Business Name): ROXANNA SANTANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROXANNA GEARA SANTANA MD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 10/12/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11255 SW 211TH ST
MIAMI FL
33189-2240
US

IV. Provider business mailing address

12171 SW 268TH ST
HOMESTEAD FL
33032-8001
US

V. Phone/Fax

Practice location:
  • Phone: 786-430-3333
  • Fax:
Mailing address:
  • Phone: 305-278-0200
  • Fax: 305-851-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME80962
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME80962
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: