Provider Demographics
NPI:1477440469
Name:SANTANA, DEMITRIUS
Entity type:Individual
Prefix:
First Name:DEMITRIUS
Middle Name:
Last Name:SANTANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 LAKE DEBRA DR APT 2525
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6640
Mailing Address - Country:US
Mailing Address - Phone:727-271-5521
Mailing Address - Fax:
Practice Address - Street 1:1000 COLOR PL STE 101
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-7717
Practice Address - Country:US
Practice Address - Phone:888-769-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician