Provider Demographics
NPI:1699274217
Name:SANTANA, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
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 1:10801 SAINT MARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3776
Mailing Address - Country:US
Mailing Address - Phone:216-609-9668
Mailing Address - Fax:216-417-3351
Practice Address - Street 1:10801 SAINT MARK AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3776
Practice Address - Country:US
Practice Address - Phone:216-609-9668
Practice Address - Fax:216-417-3351
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty