Provider Demographics
NPI:1205591922
Name:QUINTANA SANTANA, ANNIA
Entity type:Individual
Prefix:
First Name:ANNIA
Middle Name:
Last Name:QUINTANA SANTANA
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 1:1850 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7383
Mailing Address - Country:US
Mailing Address - Phone:303-951-5864
Mailing Address - Fax:
Practice Address - Street 1:1850 SW 122ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7383
Practice Address - Country:US
Practice Address - Phone:303-951-5864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health