Provider Demographics
NPI:1942807011
Name:MARANTE SANTOS, YIPSY LEONOR
Entity Type:Individual
Prefix:
First Name:YIPSY
Middle Name:LEONOR
Last Name:MARANTE SANTOS
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 1:7360 SW 24TH ST STE 22A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1482
Mailing Address - Country:US
Mailing Address - Phone:786-307-5409
Mailing Address - Fax:
Practice Address - Street 1:7360 SW 24TH ST STE 22A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1482
Practice Address - Country:US
Practice Address - Phone:786-307-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108225300Medicaid