Healthcare Provider Details

I. General information

NPI: 1285739425
Provider Name (Legal Business Name): EDWARD C. SANTOIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 SW 11TH ST
OCALA FL
34471-0967
US

IV. Provider business mailing address

PO BOX 850001
ORLANDO FL
32885-0176
US

V. Phone/Fax

Practice location:
  • Phone: 352-354-9000
  • Fax: 352-620-0255
Mailing address:
  • Phone: 352-237-7646
  • Fax: 352-291-0361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME69318
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: