Provider Demographics
NPI:1851338453
Name:SANTOLAYA, JOAQUIN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOAQUIN
Middle Name:
Last Name:SANTOLAYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:JOAQUIN
Other - Middle Name:
Other - Last Name:SANTOLAYA-FORGAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 100294
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0294
Mailing Address - Country:US
Mailing Address - Phone:352-273-7580
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD BOX 100294
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1962
Practice Address - Country:US
Practice Address - Phone:352-273-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME132311207SG0202X
MA227971207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207182Medicaid
NJ0240711Medicaid
NJ190708PQ0Medicare PIN
MAG10112Medicare UPIN