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General NPI Number Information
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NPI Number | 1306144043
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Entity Type | Individual
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Provider Name | JUAN JULIO SANTANA LMT
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Gender | Male
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 7044 SW 114TH PL UNIT A
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City | MIAMI
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State | FL
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Zip | 33173-1854
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Country | US
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Telephone | 786-339-3584
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830846
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City | MIAMI
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State | FL
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Zip | 33283-0846
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Country | US
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Telephone | 786-339-3584
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 60415
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License Number State | FL
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