Provider Demographics
NPI:1881857225
Name:ARMANDO A SANTELICES, MD, PA
Entity Type:Organization
Organization Name:ARMANDO A SANTELICES, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTELICES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-827-3505
Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:SUITE 606
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-827-3505
Mailing Address - Fax:305-865-0037
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:SUITE 606
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-827-3505
Practice Address - Fax:305-865-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34184305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME34184OtherSTATE LICENSE