Provider Demographics
NPI:1376844514
Name:SANTIAGO CARTAGENA, GLADIMAR (MD)
Entity type:Individual
Prefix:DR
First Name:GLADIMAR
Middle Name:
Last Name:SANTIAGO CARTAGENA
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 1:19189 BLUE POND DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5609
Mailing Address - Country:US
Mailing Address - Phone:787-587-7077
Mailing Address - Fax:
Practice Address - Street 1:9309 N FLORIDA AVE STE 111
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7237
Practice Address - Country:US
Practice Address - Phone:813-444-9823
Practice Address - Fax:813-774-8881
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18070208D00000X
FLME145879207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice