Provider Demographics
NPI:1164466876
Name:SANTIAGO, RICHARD DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DENNIS
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:37814 MEDICAL ARTS CT
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-4325
Mailing Address - Country:US
Mailing Address - Phone:813-364-0792
Mailing Address - Fax:844-388-6186
Practice Address - Street 1:37814 MEDICAL ARTS CT
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-4325
Practice Address - Country:US
Practice Address - Phone:813-364-0792
Practice Address - Fax:844-388-6186
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16200208D00000X
FLACN928208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice