Provider Demographics
NPI:1811541550
Name:LOREDO, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:LOREDO
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 1:745 NW 133RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1867
Mailing Address - Country:US
Mailing Address - Phone:305-495-6269
Mailing Address - Fax:
Practice Address - Street 1:6917 COLLINS AVE APT 503
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-7205
Practice Address - Country:US
Practice Address - Phone:305-495-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-31
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst