Provider Demographics
NPI:1346754561
Name:SANTANA, NELSON ALFONSO (ARNP)
Entity Type:Individual
Prefix:MR
First Name:NELSON
Middle Name:ALFONSO
Last Name:SANTANA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15432 SW 96TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3800
Mailing Address - Country:US
Mailing Address - Phone:305-409-6092
Mailing Address - Fax:
Practice Address - Street 1:7400 SW 87TH AVE STE 240
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5458
Practice Address - Country:US
Practice Address - Phone:305-409-6092
Practice Address - Fax:305-409-6092
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9326972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily