Provider Demographics
NPI:1225162449
Name:QUINONES-SANTIAGO, TANYA RUTH (PT, DPT, MSPT)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:RUTH
Last Name:QUINONES-SANTIAGO
Suffix:
Gender:F
Credentials:PT, DPT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 TRADITION LN
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-6351
Mailing Address - Country:US
Mailing Address - Phone:407-579-0850
Mailing Address - Fax:
Practice Address - Street 1:1335 BENNETT DR UNIT 119
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7606
Practice Address - Country:US
Practice Address - Phone:407-287-6407
Practice Address - Fax:407-542-5455
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26911225100000X, 2251X0800X, 2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports