Provider Demographics
NPI:1528567203
Name:PUENTES, ANA L
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:L
Last Name:PUENTES
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:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33970-0516
Mailing Address - Country:US
Mailing Address - Phone:605-350-2967
Mailing Address - Fax:239-491-2113
Practice Address - Street 1:2516 22ND ST SW
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33976-3601
Practice Address - Country:US
Practice Address - Phone:605-350-2967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP532-012-99-748-0171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP532-012-99-748-0OtherFLDLL