Provider Demographics
NPI:1235585787
Name:SANTANA, ANA TERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:TERESA
Last Name:SANTANA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3308
Mailing Address - Country:US
Mailing Address - Phone:954-579-4096
Mailing Address - Fax:833-375-3114
Practice Address - Street 1:292 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-579-4096
Practice Address - Fax:833-375-3114
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9518103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist