Provider Demographics
NPI:1023395365
Name:SANTISO PT, INC
Entity type:Organization
Organization Name:SANTISO PT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTISO
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, PES
Authorized Official - Phone:954-288-7480
Mailing Address - Street 1:110 N FEDERAL HWY APT 915
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3515
Mailing Address - Country:US
Mailing Address - Phone:954-288-7480
Mailing Address - Fax:
Practice Address - Street 1:110 N FEDERAL HWY APT 915
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-3515
Practice Address - Country:US
Practice Address - Phone:954-288-7480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFU810AOtherMEDICARE PTAN