Individual
ELOISA G. SANTILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1717 S. ORANGE AVE., SUITE 100, NEMOURS CHILDRENS CLINIC, ORLANDO, ORLANDO, FL 32806-2946
(407) 650-7715
(407) 650-7124
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT,, ROCKLAND, DE 19732-0191
(904) 697-4127
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP1020242
FL
367H00000X
Anesthesiologist Assistant
Primary
ARNP1020242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303912900
—
FL
01
—
G2924
BCBS
FL
Enumeration date
05/24/2006
Last updated
09/07/2012
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