Provider Demographics
NPI:1235974825
Name:SANTANDER MEDICAL CARE, LLC
Entity type:Organization
Organization Name:SANTANDER MEDICAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-269-1178
Mailing Address - Street 1:175 FONTAINEBLEAU BLVD STE 2A3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-7013
Mailing Address - Country:US
Mailing Address - Phone:786-947-5250
Mailing Address - Fax:
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 2A3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-7013
Practice Address - Country:US
Practice Address - Phone:786-947-5250
Practice Address - Fax:786-947-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty