Carlos Yamil Santiago Gonzalez, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15313 Issued in PR

Practice address

2600 Industrial Park Dr Ste C
Lakeland, FL 33801-7135

Phone

(863) 666-6100

Fax

(863) 248-4395

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mennonite General Hospital Inc

  • General Acute Care Hospital
  • Aibonito, PR
  • NPI 1851320394
  Medicare reassignment NPD
• Mennonite General Hospital Inc

  • Specialist
  • Aibonito, PR
  • NPI 1043347768
  NPD
• Mennonite General Hospital Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ponce, PR
  • NPI 1144099813
  NPD

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613865600000",
    "number": "1700912417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 SW 268TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328001",
            "telephone_number": "305-278-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 INDUSTRIAL PARK DR STE C",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338017135",
            "telephone_number": "863-666-6100",
            "fax_number": "863-248-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO GONZALEZ",
        "first_name": "CARLOS",
        "middle_name": "YAMIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2021-02-21",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "15313",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Santana Rodriguez, MD
• Glenda Santana
• Maria Emperatriz Santana
• Axel Javier Santiago Carlo, MD
• Juan Ramon Santiago Colon, MD
• Lisbeth Stephany Santiago Mercedes
• Hector M Santiago, CRNA
• Lyanne Santiago
• Mary Ann Veronica Santiago, LMHC
• Yoel Alfonso Santiago Jr., BEHAVIOR TECHNICIAN

• Internal Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.

Verify at the official NPI Registry.