MEDICARE: MR. AARON RICHARD SANTISO MPT, PES, CLT

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
1	225100000X	Physical Therapist	PT 21532	FL

General Provider Information

NPI Number	:	1245252154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AARON RICHARD SANTISO MPT, PES, CLT

Provider Business Mailing Address
First Line	:	3200 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1062
Country	:	US
Telephone Number	:	954-533-5543
Fax Number	:	754-223-2596

Provider Business Practice Location Address
First Line	:	3000 BAYVIEW DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1772
Country	:	US
Telephone Number	:	954-533-5543
Fax Number	:	754-223-2596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	03/17/2018

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