Provider Demographics
NPI:1205416518
Name:SALAS SILVA, ANA CRISTINA (SA-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CRISTINA
Last Name:SALAS SILVA
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18245 NW 68TH AVE APT 113
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3464
Mailing Address - Country:US
Mailing Address - Phone:786-740-9512
Mailing Address - Fax:
Practice Address - Street 1:18245 NW 68TH AVE APT 113
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3464
Practice Address - Country:US
Practice Address - Phone:786-740-9512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-11
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19-350246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant