Provider Demographics
NPI:1558384586
Name:SANTI, ANTONIO (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:SANTI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15531 SW 147TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-5505
Mailing Address - Country:US
Mailing Address - Phone:786-863-4356
Mailing Address - Fax:305-477-3599
Practice Address - Street 1:3901 NW 79TH AVE
Practice Address - Street 2:SUITE 119
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6554
Practice Address - Country:US
Practice Address - Phone:305-599-0442
Practice Address - Fax:305-477-3599
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4070101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ01SLOtherBLUE CROSS BLUE SHIELD OF FLORIDA