| Santiago W Calderon Md Pa | |
|
1840 Classique Lane Tavares FL 32778 | |
| (352) 360-9687 | |
| Not Available |
| Full Name | Santiago W Calderon Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1840 Classique Lane, Tavares, Florida |
| Authorized Official Name and Position | Santiago W Calderon (PRESIDENT) |
| Authorized Official Contact | 4072685415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santiago W Calderon Md Pa 4916 San Marino Cir Lake Mary FL 32746-2608 Ph: (407) 268-5415 | Santiago W Calderon Md Pa 1840 Classique Lane Tavares FL 32778 Ph: (352) 360-9687 |
| NPI Number | 1871745976 |
|---|---|
| Provider Enumeration Date | 10/21/2008 |
| Last Update Date | 03/16/2010 |
| Medicare PECOS PAC ID | 9638235153 |
|---|---|
| Medicare Enrollment ID | O20090309000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871745976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME70874 (Florida) | Primary |
| Provider Name | Santiago W Calderon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1790755759 PECOS PAC ID: 4486548229 Enrollment ID: I20090124000085 |
| Provider Name | Lisa M Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033534284 PECOS PAC ID: 8224260955 Enrollment ID: I20140411001557 |
| Provider Name | Laurette Que Cornel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942691373 PECOS PAC ID: 4789900598 Enrollment ID: I20150312002380 |
| Provider Name | Yulisa Astudillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871003574 PECOS PAC ID: 9537409958 Enrollment ID: I20191105001408 |
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