Basic Information
| Provider Information | |||||||||
| NPI: | 1265687008 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTIAGO FIGUEREO MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | SUITE 540 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866232000 | ||||||||
| FaxNumber: | 7863640532 | ||||||||
| Practice Location | |||||||||
| Address1: | 21097 NE 27TH CT | ||||||||
| Address2: | STE 540 | ||||||||
| City: | AVENTURA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331801204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866232000 | ||||||||
| FaxNumber: | 7863640532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2008 | ||||||||
| LastUpdateDate: | 12/13/2011 | ||||||||
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| AuthorizedOfficialLastName: | FIGUEREO | ||||||||
| AuthorizedOfficialFirstName: | SANTIAGO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7866232000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 6323770001 | FL | N | Suppliers | Durable Medical Equipment & Medical Supplies | 207T00000X | ME94748 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2800830700 | 05 | FL | MEDICAID | DQ7250 | 01 | FL | RAILROAD MEDICARE | OTHER |