Healthcare Provider Details

I. General information

NPI: 1801819396
Provider Name (Legal Business Name): MARIA EUGENIA SANTIAGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BAILEY LN STE 200
NAPLES FL
34105-8523
US

IV. Provider business mailing address

3200 BAILEY LN STE 200
NAPLES FL
34105-8523
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-8971
  • Fax: 239-262-2537
Mailing address:
  • Phone: 239-262-8971
  • Fax: 239-262-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number17351
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number96767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: