Widalys Santiago Miranda, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN885 Issued in FL

Practice address

140 W Government St
Pensacola, FL 32502-5703

Phone

(918) 616-3366

NPI assigned

Jan 14, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104063023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4274",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325724274",
            "telephone_number": "918-616-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W GOVERNMENT ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025703",
            "telephone_number": "918-616-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO MIRANDA",
        "first_name": "WIDALYS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17440",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN MEDICAL  LICENSE",
            "identifier": "ACN885",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria R. Sangillo, D.C., C.S.S.P.
• Afolabi Olakunle Sangosanya, M.D.
• Laurie Sansbury, DO
• Lillie Sansing, MD
• Valdineia Santana de Oliveira
• Michelle Santiago, ARNP
• Taylor Santiago
• Cody Santora
• Kimberlei Renee Sapp
• Shanna Sapp

• General Practice Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.