Provider Demographics
NPI:1235468315
Name:SANTIESTEBAN, OSVALDO (RN)
Entity Type:Individual
Prefix:MR
First Name:OSVALDO
Middle Name:
Last Name:SANTIESTEBAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14967 NW 91ST CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1345
Mailing Address - Country:US
Mailing Address - Phone:786-718-2820
Mailing Address - Fax:
Practice Address - Street 1:14967 NW 91ST CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-1345
Practice Address - Country:US
Practice Address - Phone:786-718-2820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9240772163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse