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NPI Code Detail

MEDICARE: PATRICE JOVITA SANTIAGO VIGILIA-ABRENICA M.D.

MEDICARE:   PATRICE JOVITA SANTIAGO VIGILIA-ABRENICA  M.D.
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
12080P0210XPediatric Nephrology PhysicianME146521FL
2208000000XPediatrics PhysicianME146521FL

General Provider Information

NPI Number : 1356726350
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICE JOVITA SANTIAGO VIGILIA-ABRENICA M.D.
Provider Business Mailing Address
First Line : PO BOX 100296
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0296
Country : US
Telephone Number : 352-627-9350
Fax Number : 352-273-9054
Provider Business Practice Location Address
First Line : 25827 SE HIGHWAY 19
Second Line :
City : OLD TOWN
State : FL
Zip : 32680-3997
Country : US
Telephone Number : 352-542-0068
Fax Number : 352-542-1843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2015
Last Update Date : 01/18/2022

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Directions to “ PATRICE JOVITA SANTIAGO VIGILIA-ABRENICA M.D.” Practice Location

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