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NPI Code Detail

MEDICARE: MIRANDA ROSE SANTIAGO

MEDICARE: MIRANDA ROSE SANTIAGO
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1457136954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRANDA ROSE SANTIAGO
Provider Business Mailing Address
First Line : 204 BREADEN ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44502-1834
Country : US
Telephone Number : 407-391-4781
Fax Number :
Provider Business Practice Location Address
First Line : 204 BREADEN ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44502-1834
Country : US
Telephone Number : 407-391-4781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2023
Last Update Date : 03/27/2024

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Directions to “ MIRANDA ROSE SANTIAGO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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