Provider Demographics
NPI:1699144436
Name:SANTOPADRE, DIANE (ARNP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SANTOPADRE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PLANTATION ISLAND DR S STE 103
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3109
Mailing Address - Country:US
Mailing Address - Phone:904-461-5330
Mailing Address - Fax:904-461-5334
Practice Address - Street 1:1301 PLANTATION ISLAND DR S STE 103
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3109
Practice Address - Country:US
Practice Address - Phone:904-461-5330
Practice Address - Fax:904-461-5334
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2858672363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health