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1164875662 NPI number — VANESSA SOSTRE SANTIAGO MD

NPI Number: 1164875662
Health Care Provider/Practitioner: VANESSA SOSTRE SANTIAGO MD

Information about “1164875662” NPI (VANESSA SOSTRE SANTIAGO MD) exists in 1164875662 in HTML format HTML  |  1164875662 in plain Text format TXT  |  1164875662 in PDF (Portable Document Format) PDF  |  1164875662 in an XML format XML  formats.

NPI Number : 1164875662 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164875662",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SOSTRE SANTIAGO",
    "FirstName": "VANESSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5101 SW 8TH STREET",
    "SecondLineMailingAddress": "SUITE 200",
    "MailingAddressCityName": "CORAL GABLES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33134-2442",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-359-5037",
    "MailingAddressFaxNumber": "786-509-5544",
    "FirstLinePracticeLocationAddress": "10305 NW 41ST STREET",
    "SecondLinePracticeLocationAddress": "SUITE 212",
    "PracticeLocationAddressCityName": "DORAL",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33178",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-791-0316",
    "PracticeLocationAddressFaxNumber": "305-774-5916",
    "EnumerationDate": "07/20/2016",
    "LastUpdateDate": "02/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RG0100X",
        "TaxonomyName": "Gastroenterology Physician",
        "LicenseNumber": "ME155495",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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