MEDICARE: CLAUDETTE DAISY SANTOS MS, OTR

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	225X00000X	Occupational Therapist	OT19231	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1396269692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDETTE DAISY SANTOS MS, OTR

Provider Business Mailing Address
First Line	:	400 E MOSHOLU PKWY S APT B2
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-1775
Country	:	US
Telephone Number	:	347-282-7248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 S HIAWASSEE RD STE 203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-6317
Country	:	US
Telephone Number	:	718-708-6043
Fax Number	:

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

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	10/19/2023

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