Provider Demographics
NPI:1063114346
Name:SANTANA, SOFIA VALERIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:VALERIA
Last Name: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 1:8501 SW 27TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2340
Mailing Address - Country:US
Mailing Address - Phone:305-333-3550
Mailing Address - Fax:
Practice Address - Street 1:2894 NW 79TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1033
Practice Address - Country:US
Practice Address - Phone:305-597-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst