Individual
SANTIAGO GANCAYCO DE LOS ANGELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2120 SARNO RD, MELBOURNE, FL 32935-3084
(321) 241-6800
(321) 241-6888
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME65644
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME65644
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021329000
—
FL
Enumeration date
11/21/2006
Last updated
01/30/2025
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