Provider Demographics
NPI:1629416607
Name:SANTIAGO, BENEDICTO TANYAG (RRT)
Entity Type:Individual
Prefix:MR
First Name:BENEDICTO
Middle Name:TANYAG
Last Name:SANTIAGO
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 NW 15TH STREET RD
Mailing Address - Street 2:UNIT 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1612
Mailing Address - Country:US
Mailing Address - Phone:786-340-6047
Mailing Address - Fax:
Practice Address - Street 1:1545 NW 15TH STREET RD
Practice Address - Street 2:UNIT 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1612
Practice Address - Country:US
Practice Address - Phone:786-340-6047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT104242278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health