Provider Demographics
NPI:1871748590
Name:SANTANA, MIGUEL ANTONIO (LPN)
Entity type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:ANTONIO
Last Name:SANTANA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1863 SW 11TH ST
Mailing Address - Street 2:APT5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-5141
Mailing Address - Country:US
Mailing Address - Phone:786-222-5011
Mailing Address - Fax:
Practice Address - Street 1:1863 SW 11 ST
Practice Address - Street 2:APT5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135
Practice Address - Country:US
Practice Address - Phone:786-222-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5160173164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse