Provider Demographics
NPI:1710202007
Name:SANTIN AND ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:SANTIN AND ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ENMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-281-0588
Mailing Address - Street 1:7000 W 12TH AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5154
Mailing Address - Country:US
Mailing Address - Phone:305-362-0400
Mailing Address - Fax:305-362-0780
Practice Address - Street 1:7000 W 12TH AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5154
Practice Address - Country:US
Practice Address - Phone:305-362-0400
Practice Address - Fax:305-362-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002117400Medicaid