Individual
MIA SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
259 BILL FRANCE BLVD, SUITE 200, DAYTONA BEACH, FL 32114-1316
(386) 868-1992
Mailing address
904 GOLDEN LAKE LOOP, SAINT AUGUSTINE, FL 32084-5877
(904) 679-8728
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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