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Individual

DR. SANTIAGO HAMLET PENA BAEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2776 CLEVELAND AVE, FORT MYERS, FL 33901-5855
(239) 343-2052
(239) 343-5348
Mailing address
P.O. BOX 2147, FORT MEYERS, FL 33902-2147
(239) 343-2052
(239) 343-5348

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME116158
FL
208M00000X
Hospitalist Physician
Primary
ME116158
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102075500
FL
Enumeration date
01/26/2013
Last updated
03/29/2021
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