Provider Demographics
NPI:1720213176
Name:CANETTI-VALDESUSO, ANA MARGARITA (BA)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:MARGARITA
Last Name:CANETTI-VALDESUSO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2281 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3433
Mailing Address - Country:US
Mailing Address - Phone:305-854-1050
Mailing Address - Fax:
Practice Address - Street 1:2281 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3433
Practice Address - Country:US
Practice Address - Phone:305-854-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker