Active NPI
Olguimer Santiago Lopez, FNP
- Nurse Practitioner
- Orlando, FL
National Provider Identifier
1083209183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 11011867
- Practice address
- 1812 N Mills Ave
Orlando, FL 32803-1834 - Phone
- (407) 897-3499
- NPI assigned
- Mar 2, 2021
- Last updated
- Mar 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 11011867 | FL | Primary |
Addresses
Primary practice location
1812 N Mills Ave
Orlando, FL 32803-1834
Mailing address
293 Trinity Ridge Cir
Davenport, FL 33897-7501
Phone (787) 215-9141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211008000358 | FL | Order and Referring Only - Nurse Practitioner | 8123426905 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11011867 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614816000000",
"number": "1083209183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "293 TRINITY RIDGE CIR",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338977501",
"telephone_number": "787-215-9141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 N MILLS AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328031834",
"telephone_number": "407-897-3499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO LOPEZ",
"first_name": "OLGUIMER",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-02",
"last_updated": "2021-03-04",
"certification_date": "2021-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "11011867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
- Noris Leonis Santiago Castellano
- Carlos Manuel Santiago Colon, PSYD
- Veronica Santiago de Jesus
- Santiago E. Martinez, M.D., PA
- Glorimar Santiago Laboy
- Cristine Marie Santiago Montalvo, M.D.
- Marcos Santiago Moreno, PMHNP
- Demian Jesus Santiago Ortiz
- Zulmarelis Santiago Ortiz
- Elizabeth Jeanine Santiago Torres, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.