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NPI Code Detail

MEDICARE: IDALMIS SANTANA-PORBEN MD

MEDICARE:   IDALMIS  SANTANA-PORBEN  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
1207Q00000XFamily Medicine PhysicianME88244FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649280918
Entity Type Code : Individual
Provider Name (Legal Business Name) : IDALMIS SANTANA-PORBEN MD
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15516 SW 88TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33196-1554
Country : US
Telephone Number : 305-387-3300
Fax Number : 888-857-3579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 02/18/2026

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Directions to “ IDALMIS SANTANA-PORBEN MD” Practice Location

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