Individual
JENNIFER SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9508 WINDERMERE PARK CIRCLE APT 203, RIVERVIEW, FL 33578
(407) 625-4354
Mailing address
9508 WINDERMERE PARK CIRCLE APT 203, RIVERVIEW, FL 33578
(407) 625-4354
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
25C00000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
590179
—
FL
Enumeration date
05/22/2015
Last updated
05/22/2015
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