Provider Demographics
NPI:1619417045
Name:SANTIAGO TORRES, ELIZABETH JEANINE (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JEANINE
Last Name:SANTIAGO TORRES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13057 GABOR AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-3854
Mailing Address - Country:US
Mailing Address - Phone:954-668-3359
Mailing Address - Fax:
Practice Address - Street 1:13057 GABOR AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-3854
Practice Address - Country:US
Practice Address - Phone:954-668-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-04
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23250122300000X
MO2017020305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist