Basic Information
| Provider Information | |||||||||
| NPI: | 1164154175 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALEANO LOVERA | ||||||||
| FirstName: | SANTIAGO | ||||||||
| MiddleName: | FEDERICO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3050 TAMAYA BLVD APT 728 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322461259 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9044456562 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4500 SAN PABLO RD S | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322241865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9049538215 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2022 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | TRN36304 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | TRN34697 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.