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General NPI Number Information
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NPI Number | 1619867371
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Entity Type | Individual
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Provider Name | SHAELIER ABDIEL SANTIAGO
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Gender | Male
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Dates
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Enumeration Date | 07/05/2025
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 1855 W HIBISCUS BLVD
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City | MELBOURNE
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State | FL
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Zip | 32901-2622
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Country | US
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Telephone | 321-802-4521
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Fax |
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Provider Business Mailing Address
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Address Line | 143 ASCEND CIR UNIT 7203
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-8793
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Country | US
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Telephone | 571-278-8749
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH15438
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License Number State | FL
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