MEDICARE: DR. TIFFANY KRISTINA SANTIAGO 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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1265375927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIFFANY KRISTINA SANTIAGO MD

Provider Business Mailing Address
First Line	:	5355 NW EAST PADEN CIR
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-2704
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3431
Country	:	US
Telephone Number	:	478-922-4281
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/10/2026

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