Provider Demographics
NPI:1518153394
Name:VERTUS, ANA M (MPH)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:M
Last Name:VERTUS
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11967 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3223
Mailing Address - Country:US
Mailing Address - Phone:954-254-8366
Mailing Address - Fax:954-341-3839
Practice Address - Street 1:11967 NW 55TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3223
Practice Address - Country:US
Practice Address - Phone:954-254-8366
Practice Address - Fax:954-341-3839
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-21-152254106S00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL812055200Medicaid