MEDICARE: DR. RICARDO SANTAYANA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0043689	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1334389007	OTHER	FL	CIGNA
2	870408859	OTHER	FL	HUMANA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013907088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO SANTAYANA MD

Provider Business Mailing Address
First Line	:	4803 TANNERY AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-4533
Country	:	US
Telephone Number	:	813-960-0880
Fax Number	:	813-932-1923

Provider Business Practice Location Address
First Line	:	3201 W WATERS AVE
Second Line	:	SUITE B
City	:	TAMPA
State	:	FL
Zip	:	33614-2879
Country	:	US
Telephone Number	:	813-932-7303
Fax Number	:	813-932-1923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/21/2014

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