Provider Demographics
NPI:1720574411
Name:SANTANA, MAILYN (MD)
Entity type:Individual
Prefix:DR
First Name:MAILYN
Middle Name:
Last Name:SANTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAILYN
Other - Middle Name:
Other - Last Name:SANTANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5901 SW 74TH ST STE 211
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5150
Mailing Address - Country:US
Mailing Address - Phone:786-228-6892
Mailing Address - Fax:
Practice Address - Street 1:5901 SW 74TH ST STE 211
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5150
Practice Address - Country:US
Practice Address - Phone:786-228-6892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023007822084P0800X, 2084P0802X, 2084P0804X
FLME1514562084P0802X, 2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry