Provider Demographics
NPI:1477109551
Name:OTERO, DANAE DE' ANA
Entity Type:Individual
Prefix:
First Name:DANAE
Middle Name:DE' ANA
Last Name:OTERO
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 1:10380 SW 216TH ST APT 106
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1702
Mailing Address - Country:US
Mailing Address - Phone:786-709-7866
Mailing Address - Fax:
Practice Address - Street 1:10380 SW 216TH ST APT 106
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1702
Practice Address - Country:US
Practice Address - Phone:786-709-7866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician