Provider Demographics
NPI:1336775725
Name:NUBIA SANTOS MS MED LMHC
Entity Type:Organization
Organization Name:NUBIA SANTOS MS MED LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NUBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD MHC
Authorized Official - Phone:561-212-0541
Mailing Address - Street 1:250 NW 40TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5740
Mailing Address - Country:US
Mailing Address - Phone:561-212-0541
Mailing Address - Fax:
Practice Address - Street 1:25 SE 2ND AVE STE 313
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1509
Practice Address - Country:US
Practice Address - Phone:561-212-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty