Provider Demographics
NPI:1689557548
Name:SANTIAGO, YOEL ALFONSO JR (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:MR
First Name:YOEL
Middle Name:ALFONSO
Last Name:SANTIAGO
Suffix:JR
Gender:M
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
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Mailing Address - Street 1:4040 RADIANT MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-6020
Mailing Address - Country:US
Mailing Address - Phone:813-503-0850
Mailing Address - Fax:
Practice Address - Street 1:600 LAKE HOLLINGSWORTH DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2364
Practice Address - Country:US
Practice Address - Phone:844-854-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician