Provider Demographics
NPI:1235643263
Name:VENEGAS BELTRAN, ANA ELIA
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:ELIA
Last Name:VENEGAS BELTRAN
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 1:140 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4422
Mailing Address - Country:US
Mailing Address - Phone:786-362-1553
Mailing Address - Fax:
Practice Address - Street 1:140 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4422
Practice Address - Country:US
Practice Address - Phone:786-362-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician