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NPI Code Detail

MEDICARE: ELIANNE SANTANA

MEDICARE:   ELIANNE  SANTANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental TherapistS535-214-90-689-0FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003328584
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIANNE SANTANA
Provider Business Mailing Address
First Line : 4800 N FEDERAL HWY STE 104
Second Line :
City : BOCA RATON
State : FL
Zip : 33431-5188
Country : US
Telephone Number : 617-470-9827
Fax Number : 561-372-2651
Provider Business Practice Location Address
First Line : 2832 FLAMANGO LAKE DR
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-4308
Country : US
Telephone Number : 561-531-0371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2017
Last Update Date : 10/24/2017

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Directions to “ ELIANNE SANTANA ” Practice Location

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