Provider Demographics
NPI:1972297976
Name:SANTIAGO, CYNTHIA YULIZA
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:YULIZA
Last Name:SANTIAGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:YULIZA
Other - Last Name:VIERA MATUTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9390 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2449
Mailing Address - Country:US
Mailing Address - Phone:719-439-3558
Mailing Address - Fax:
Practice Address - Street 1:9390 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2449
Practice Address - Country:US
Practice Address - Phone:719-439-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician