Provider Demographics
NPI:1790267045
Name:SANTANDER, TERESITA DE JESUS (ARNP)
Entity Type:Individual
Prefix:
First Name:TERESITA
Middle Name:DE JESUS
Last Name:SANTANDER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 WEST 43DR PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:786-269-1178
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST STE 118
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2038
Practice Address - Country:US
Practice Address - Phone:786-502-2100
Practice Address - Fax:786-502-2044
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9324197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily