Active NPI
Jennifer Santiago
- Developmentally Disabled Services Day Training Agency
- Riverview, FL
National Provider Identifier
1538548532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- License
- 25C00000X
- Practice address
- 9508 Windermere Park Circle Apt 203
Riverview, FL 33578 - Phone
- (407) 625-4354
- NPI assigned
- May 22, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 25C00000X | FL | Primary |
Addresses
Primary practice location
9508 Windermere Park Circle Apt 203
Riverview, FL 33578
Mailing address
9508 Windermere Park Circle Apt 203
Riverview, FL 33578
Phone (407) 625-4354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590179 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25C00000X | FL | MD | Developmentally Disabled Services Day Training Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432252800000",
"number": "1538548532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9508 WINDERMERE PARK CIRCLE APT 203",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "33578",
"telephone_number": "407-625-4354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9508 WINDERMERE PARK CIRCLE APT 203",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "33578",
"telephone_number": "407-625-4354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-22",
"last_updated": "2015-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "FL",
"license": "25C00000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "590179",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.