Provider Demographics
NPI:1609320456
Name:SANTIAGO, MELISSA (ARNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ABADY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3830 TAMPA RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-5619
Mailing Address - Country:US
Mailing Address - Phone:727-786-6155
Mailing Address - Fax:
Practice Address - Street 1:3830 TAMPA RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-5619
Practice Address - Country:US
Practice Address - Phone:727-786-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9234388363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care