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General NPI Number Information
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NPI Number | 1427360593
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Entity Type | Individual
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Provider Name | MADAI ORTIZ-SANTIAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 1613 HARRISON PKWY RADIOLOGY DIVISION, SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33323-2896
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Country | US
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Telephone | 954-514-4843
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 HARRISON PKWY RADIOLOGY DIVISION, SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33323-2896
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Country | US
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Telephone | 954-514-4843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MT191825
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301087461
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License Number State | MI
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