Provider Demographics
NPI:1295851939
Name:PERIU, OSMANY SANTIGAO (DC)
Entity Type:Individual
Prefix:DR
First Name:OSMANY
Middle Name:SANTIGAO
Last Name:PERIU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5828
Mailing Address - Country:US
Mailing Address - Phone:561-361-8989
Mailing Address - Fax:561-361-4401
Practice Address - Street 1:399 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5828
Practice Address - Country:US
Practice Address - Phone:561-361-8989
Practice Address - Fax:561-361-4401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22632Medicare ID - Type Unspecified
FLU16878Medicare UPIN