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Individual

DR. ROBERTO ANTONIO MIRANDA SANTIAGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2501 S VANCE DR STE A, FLORENCE, SC 29505-6163
(843) 679-4019
(843) 679-4022
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37361
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
373615
SC
Enumeration date
06/15/2006
Last updated
03/05/2021
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