Provider Demographics
NPI:1194616896
Name:SANTIAGO, LIZAIDA (RBT)
Entity type:Individual
Prefix:
First Name:LIZAIDA
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 CAMEL CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4315
Mailing Address - Country:US
Mailing Address - Phone:407-724-6160
Mailing Address - Fax:
Practice Address - Street 1:720 CAMEL CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4315
Practice Address - Country:US
Practice Address - Phone:407-724-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-447776106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician