Healthcare Provider Details

I. General information

NPI: 1912681545
Provider Name (Legal Business Name): SANTIAGO JORGE CAMPOS ABAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NE 123RD ST STE 414
NORTH MIAMI FL
33181-2884
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 305-981-0600
  • Fax: 305-981-2700
Mailing address:
  • Phone: 305-981-0600
  • Fax: 305-981-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME179234
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: