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General NPI Number Information
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NPI Number | 1548842768
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Entity Type | Individual
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Provider Name | SANTIAGO KRUMM CABEZAS
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Gender | Male
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 3414 LOGGERHEAD WAY
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7709
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Country | US
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Telephone | 339-204-7858
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Fax |
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Provider Business Mailing Address
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Address Line | 10905 RUSTIC TIMBER LOOP
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City | SAN ANTONIO
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State | FL
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Zip | 33576-7395
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Country | US
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Telephone | 339-204-7858
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 281990
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME169707
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License Number State | FL
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