Provider Demographics
NPI:1518663418
Name:ARTIMEZ BAEZ, ANA ELBA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ELBA
Last Name:ARTIMEZ BAEZ
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 1:11150 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1377
Mailing Address - Country:US
Mailing Address - Phone:786-280-3709
Mailing Address - Fax:
Practice Address - Street 1:11150 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1377
Practice Address - Country:US
Practice Address - Phone:786-280-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20129740106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician