Provider Demographics
NPI:1598137598
Name:SANTIAGO, HECTOR FELIPE (RN, BSN, PMD, PTA)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:FELIPE
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:RN, BSN, PMD, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14550 OLD SAINT AUGUSTINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-2460
Mailing Address - Country:US
Mailing Address - Phone:904-271-6000
Mailing Address - Fax:
Practice Address - Street 1:14550 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2460
Practice Address - Country:US
Practice Address - Phone:904-271-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN95693812086S0102X, 163WC0200X, 2084A2900X
FLPTA26238225200000X
FLPMD541591146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care