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General NPI Number Information
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NPI Number | 1871745976
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Entity Type | Organization
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Legal Business Name | SANTIAGO W CALDERON MD PA
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 60 MEMORIAL MEDICAL PKWY
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City | PALM COAST
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State | FL
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Zip | 32164-5980
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Country | US
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Telephone | 706-529-8953
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Fax | 706-410-2421
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Provider Business Mailing Address
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Address Line | 4916 SAN MARINO CIR
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City | LAKE MARY
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State | FL
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Zip | 32746-2608
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Country | US
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Telephone | 706-529-8953
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANTIAGO W CALDERON
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Credential | MD
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Telephone | 706-529-8953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME70874
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License Number State | FL
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