Individual
ELIAS JORGE SANTIESTEBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1408 NE 1ST AVE, HOMESTEAD, FL 33030-4535
(305) 242-1399
Mailing address
33463 SW 197TH AVE, HOMESTEAD, FL 33034-1509
(786) 255-8977
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12499
FL
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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