Provider Demographics
NPI:1053621292
Name:SANTIAGO GONZALEZ, EVELYN V (CRNA)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:V
Last Name:SANTIAGO GONZALEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:1329 SW 16TH ST RM 2232
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1128
Mailing Address - Country:US
Mailing Address - Phone:352-733-0485
Mailing Address - Fax:
Practice Address - Street 1:1545 HAND AVE STE A1
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-1140
Practice Address - Country:US
Practice Address - Phone:386-274-2977
Practice Address - Fax:386-274-2997
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9253474367500000X
FLAPRN9253474367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered