Provider Demographics
NPI:1245007145
Name:RETANA, ANA BEATRIZ
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:BEATRIZ
Last Name:RETANA
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 1:1213 NW 125TH TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3128
Mailing Address - Country:US
Mailing Address - Phone:954-554-2199
Mailing Address - Fax:
Practice Address - Street 1:1213 NW 125TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3128
Practice Address - Country:US
Practice Address - Phone:954-554-2199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician