Provider Demographics
NPI:1053100123
Name:FLOREZ, ANA MILENA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MILENA
Last Name:FLOREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6874 AXIS WEST CIR APT 4415
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6113
Mailing Address - Country:US
Mailing Address - Phone:786-355-3173
Mailing Address - Fax:
Practice Address - Street 1:730 SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7750
Practice Address - Country:US
Practice Address - Phone:407-214-5539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-120992106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician