Provider Demographics
NPI:1386693877
Name:TAPIA SANTIAGO, CECILLE (MD)
Entity type:Individual
Prefix:DR
First Name:CECILLE
Middle Name:
Last Name:TAPIA SANTIAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2031
Mailing Address - Country:US
Mailing Address - Phone:321-843-5523
Mailing Address - Fax:321-843-2068
Practice Address - Street 1:83 W MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2031
Practice Address - Country:US
Practice Address - Phone:321-843-5523
Practice Address - Fax:321-843-2068
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD214729207V00000X
GA92621207V00000X
LA330479207V00000X
FLME0070976207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104969400Medicaid
FL31386OtherBCBS
FL5465127OtherAETNA PPO
FL2611435OtherAETNA HMO
FL7688359001OtherCIGNA
FL31386OtherBCBS
FLG38267Medicare UPIN