Provider Demographics
NPI:1952078891
Name:LAMAS, MIRTHA SANTA (HHA)
Entity Type:Individual
Prefix:
First Name:MIRTHA
Middle Name:SANTA
Last Name:LAMAS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2162 W 60TH ST APT 14105
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2620
Mailing Address - Country:US
Mailing Address - Phone:305-206-4439
Mailing Address - Fax:
Practice Address - Street 1:12460 SW 8TH ST STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1437
Practice Address - Country:US
Practice Address - Phone:305-206-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-27
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL784555374U00000X
FL3814374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide