Fallon, Santiago

Fallon, Santiago is an sole proprietor health care provider with primary practice located at 1385 W State Road 434 Suite 103, Longwood FL 32750-6871. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Fallon, Santiago can be contacted via phone (407) 462-6133.

Contact Information

Primary practice address
1385 W State Road 434 Suite 103 Longwood FL 32750-6871
Phone: (407) 462-6133
Fax: (407) 332-6226
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH7320 Florida

Profile Details

NPI number 1043360951
LBN Legal business name Fallon, Santiago
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2007
Last updated Nov 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043360951 NPPES
Florida MEDICAID 7647107 00

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