Provider Demographics
NPI:1588226047
Name:MOSQUERA, ANA MARIA (PHD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:MOSQUERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4769
Mailing Address - Country:US
Mailing Address - Phone:407-795-3698
Mailing Address - Fax:
Practice Address - Street 1:6000 TURKEY LAKE RD STE 211
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4206
Practice Address - Country:US
Practice Address - Phone:407-370-2288
Practice Address - Fax:407-370-2346
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist