Provider Demographics
NPI:1790204147
Name:SANTANIELLO, MARIANGELA
Entity type:Individual
Prefix:
First Name:MARIANGELA
Middle Name:
Last Name:SANTANIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 RIVERSIDE DR APT 311
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7040
Mailing Address - Country:US
Mailing Address - Phone:754-246-1249
Mailing Address - Fax:
Practice Address - Street 1:927 RIVERSIDE DR APT 311
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7040
Practice Address - Country:US
Practice Address - Phone:754-246-1249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other