Provider Demographics
NPI:1225816895
Name:SALAME PENA, ANA CLAUDIA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CLAUDIA
Last Name:SALAME PENA
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 1:7747 SW 86TH ST APT 110D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7280
Mailing Address - Country:US
Mailing Address - Phone:786-291-0554
Mailing Address - Fax:
Practice Address - Street 1:530 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4468
Practice Address - Country:US
Practice Address - Phone:305-654-7251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health