Individual
LAUREANO ANTONIO SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5650
(904) 542-7300
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9116787
FL
Other
Enumeration date
03/18/2021
Last updated
09/19/2023
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