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General NPI Number Information
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NPI Number | 1184092421
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Entity Type | Individual
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Provider Name | MELISSA SANTIAGO
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Gender | Female
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 2243 NORTH BLVD W
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City | DAVENPORT
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State | FL
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Zip | 33837-8990
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Country | US
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Telephone | 813-573-4641
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Fax |
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Provider Business Mailing Address
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Address Line | 10195 ANCORA CIR APT 2201
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City | ORLANDO
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State | FL
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Zip | 32821-7450
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Country | US
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Telephone | 813-573-4641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-17-7771
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License Number State | FL
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