Individual
MR. CLINT JAMES SANTIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 323-5762
Mailing address
1329 SW 16TH ST RM 2232, GAINESVILLE, FL 32608-1128
(352) 559-5051
(352) 265-8018
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11013006
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110504400
—
FL
Enumeration date
12/28/2019
Last updated
10/19/2023
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