Individual
SANTIAGO JESUS FORTEZA ALUICIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1990 N FEDERAL HWY, POMPANO BEACH, FL 33062-1032
(954) 942-2247
Mailing address
14343 SW 97TH LN, MIAMI, FL 33186-1157
(786) 307-7852
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
024277
PR
208D00000X
General Practice Physician
Primary
ACN1714
FL
Other
Enumeration date
03/06/2025
Last updated
04/17/2025
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