Provider Demographics
NPI:1417456153
Name:GOUVEA, ANA CRISTINA (MHC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CRISTINA
Last Name:GOUVEA
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7910 HARBOR ISLAND DR APT 803
Mailing Address - Street 2:
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3388
Mailing Address - Country:US
Mailing Address - Phone:305-877-9940
Mailing Address - Fax:
Practice Address - Street 1:10570 NW 27TH ST STE 102
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2105
Practice Address - Country:US
Practice Address - Phone:305-629-8276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health