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NPI Code Detail

MEDICARE: SANTIAGO WILLMAN CALDERON PEREZ MD

MEDICARE: SANTIAGO WILLMAN CALDERON PEREZ 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
1174400000XSpecialistME 70874FL
2207RI0200XInfectious Disease PhysicianME 70874FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5440001648OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000830802OTHERFLHUMANA
213935OTHERFLFL MEMORIAL HEALTH NETWOR
3150170OTHERFLHEALTHEASE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
631616OTHERFLBC/BS
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790755759
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANTIAGO WILLMAN CALDERON PEREZ MD
Provider Business Mailing Address
First Line : 4916 SAN MARINO CIR
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-2608
Country : US
Telephone Number : 386-775-1175
Fax Number : 321-256-1547
Provider Business Practice Location Address
First Line : 60 MEMORIAL MEDICAL PKWY
Second Line :
City : PALM COAST
State : FL
Zip : 32164-5980
Country : US
Telephone Number : 706-529-8953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 07/28/2025

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