Provider Demographics
NPI:1124227871
Name:SANTIAGO, YESENIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:YESENIA
Middle Name:D
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-961-3252
Mailing Address - Fax:954-964-6168
Practice Address - Street 1:4700 SHERIDAN ST
Practice Address - Street 2:SUITE C
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3420
Practice Address - Country:US
Practice Address - Phone:954-961-3252
Practice Address - Fax:954-964-6168
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2014-09-12
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Provider Licenses
StateLicense IDTaxonomies
FLME114607207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGX568ZMedicare PIN