Provider Demographics
NPI:1639319171
Name:SANTAMARIA, JOSEPH ALEXANDER (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALEXANDER
Last Name:SANTAMARIA
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 SW 18TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7715
Mailing Address - Country:US
Mailing Address - Phone:305-302-6925
Mailing Address - Fax:
Practice Address - Street 1:12400 SW 18TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7715
Practice Address - Country:US
Practice Address - Phone:305-302-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist