Jimenez, Santiago
Jimenez, Santiago is an sole proprietor health care provider with primary practice located at 1223 Gateway Dr , Melbourne FL 32901-2607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jimenez, Santiago can be contacted via phone (321) 549-0677.Contact Information
Primary practice address
1223 Gateway Dr
Melbourne FL 32901-2607
Phone: (321) 549-0677
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | BP10024058 | Texas |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME94727 | Florida |
Profile Details
| NPI number | 1073595740 |
|---|---|
| LBN Legal business name | Jimenez, Santiago |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Jan 12th, 2024 - about 8 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073595740 | NPPES |
| Florida | MEDICAID | PENDING |
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