Provider Demographics
NPI:1659693240
Name:J.A SANTIAGO, MS, RPT, P.A
Entity Type:Organization
Organization Name:J.A SANTIAGO, MS, RPT, P.A
Other - Org Name:SUNCOAST HOME HEALTH CARE SERVICES OF FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RPT, PA
Authorized Official - Phone:813-876-7400
Mailing Address - Street 1:1704 W DR MLK JR BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6508
Mailing Address - Country:US
Mailing Address - Phone:813-876-7400
Mailing Address - Fax:813-877-8145
Practice Address - Street 1:1704 W DR MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6508
Practice Address - Country:US
Practice Address - Phone:813-876-7400
Practice Address - Fax:813-877-8145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health