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LAUREANO ANTONIO SANTIAGO
NPI 1043896368
Physician Assistant - Medical in Jacksonville, FL

Active since March 18, 2021PECOS Enrolled
2080 CHILD ST, JACKSONVILLE, FL 32214(904) 542-7300 Get Directions Write a Review

NPPES record last updated: September 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Laureano Antonio Santiago NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAUREANO ANTONIO SANTIAGO (NPI 1043896368) is an individual medical provider in Jacksonville, Florida, licensed in Florida (PA9116787) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043896368
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameLAUREANO ANTONIO SANTIAGO
Location Address2080 CHILD STJacksonville, FL 32214-5650
Mailing Address2080 Child StJacksonville, FL 32214-5005 · (904) 542-7300
Phone(904) 542-7300
Sole ProprietorNo
Enumeration DateMarch 18, 2021
Last NPPES UpdateSeptember 19, 2023
NPPES CertifiedSeptember 19, 2023
✔ NPI 1043896368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · PA9116787
2080 CHILD ST, Jacksonville, FL 32214
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Laureano Antonio Santiago is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEVEN LEE UNDHEIM IDC
Military Health Care Provider (Independent Duty Corpsman)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 546-7094
RAMONA GREENE
Registered Nurse (Medical-Surgical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. HANNAH GOULD MD
Military Health Care Provider
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7762
DR. RONALD APPLEBY D.M.D
Dentist (General Practice)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3442
MS. DEBRA LYNN WAGNER CNM, ARNP
Advanced Practice Midwife
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. NICOLE MARIE THATCHER MD
General Practice
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-0409
MR. ROBERT NEWTON DOBBINS III RPH
Pharmacist
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-2537
DR. DWIGHT DAVID HART PSY.D.
Psychologist (Clinical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3473

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laureano Santiago's NPI number?

The NPI number for Laureano Santiago is 1043896368. It was assigned to this individual provider in the NPPES registry on March 18, 2021.

Where is Laureano Santiago located?

Laureano Santiago practices at 2080 Child St, Jacksonville, FL 32214. The listed phone number is (904) 542-7300.

What is Laureano Santiago's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Laureano Santiago enrolled in Medicare?

Yes. Laureano Santiago is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Laureano Santiago was last updated on September 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.