Provider Demographics
NPI:1437522752
Name:SANTIESTEBAN GARCIA, WILMER R (APRN)
Entity Type:Individual
Prefix:
First Name:WILMER
Middle Name:R
Last Name:SANTIESTEBAN GARCIA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NW 70TH AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2911
Mailing Address - Country:US
Mailing Address - Phone:954-368-3529
Mailing Address - Fax:954-333-2629
Practice Address - Street 1:150 NW 70TH AVE STE 10
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2911
Practice Address - Country:US
Practice Address - Phone:954-368-3529
Practice Address - Fax:954-333-2629
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9383548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1437522752OtherNPI