1558384586 NPI number — MR. ANTONIO SANTI LMHC

Table of content: MR. ANTONIO SANTI LMHC (NPI 1558384586)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558384586 NPI number — MR. ANTONIO SANTI LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTI
Provider First Name:
ANTONIO
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558384586
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15531 SW 147TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33187-5505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-863-4356
Provider Business Mailing Address Fax Number:
305-477-3599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 NW 79TH AVE
Provider Second Line Business Practice Location Address:
SUITE 119
Provider Business Practice Location Address City Name:
DORAL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33166-6554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-599-0442
Provider Business Practice Location Address Fax Number:
305-477-3599
Provider Enumeration Date:
07/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  MH4070 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: MH4070 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Z01SL . This is a "BLUE CROSS BLUE SHIELD OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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