Provider Demographics
NPI:1730214354
Name:SANTIAGO, ANAMARIS (OTR)
Entity type:Individual
Prefix:MRS
First Name:ANAMARIS
Middle Name:
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16500 SW 137TH AVE APT 816
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2294
Mailing Address - Country:US
Mailing Address - Phone:305-299-4251
Mailing Address - Fax:786-713-5569
Practice Address - Street 1:16500 SW 137TH AVE APT 816
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2294
Practice Address - Country:US
Practice Address - Phone:305-299-4251
Practice Address - Fax:786-713-5569
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3377225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889446900Medicaid