Provider Demographics
NPI:1649436734
Name:SANTIN, JORGE JESUS (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:JESUS
Last Name:SANTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12446 SW 9TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2601
Mailing Address - Country:US
Mailing Address - Phone:305-972-1308
Mailing Address - Fax:305-264-0253
Practice Address - Street 1:8840 BIRD RD STE 100
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5482
Practice Address - Country:US
Practice Address - Phone:786-596-3890
Practice Address - Fax:786-596-3889
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME102326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME102326OtherFLORIDA LICENSE