Provider Demographics
NPI:1285739425
Name:SANTOIAN, EDWARD C (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:C
Last Name:SANTOIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0176
Mailing Address - Country:US
Mailing Address - Phone:352-237-7646
Mailing Address - Fax:352-291-0361
Practice Address - Street 1:125 SW 11TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0967
Practice Address - Country:US
Practice Address - Phone:352-354-9000
Practice Address - Fax:352-620-0255
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69318207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21056OtherBLUE CROSS BLUE SHIELD
FL252872000Medicaid
F47322Medicare UPIN
FL252872000Medicaid
FL21056OtherBLUE CROSS BLUE SHIELD