Provider Demographics
NPI:1073227203
Name:SANTIAGO-LAM, MARIA VICTORIA G
Entity Type:Individual
Prefix:
First Name:MARIA VICTORIA
Middle Name:G
Last Name:SANTIAGO-LAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA VICTORIA
Other - Middle Name:G
Other - Last Name:SANTIAGO-LAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:338 SW 33RD TER
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-2362
Mailing Address - Country:US
Mailing Address - Phone:754-367-3745
Mailing Address - Fax:
Practice Address - Street 1:338 SW 33RD TER
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-2362
Practice Address - Country:US
Practice Address - Phone:754-367-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist