Basic Information
| Provider Information | |||||||||
| NPI: | 1437500378 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANA ANSIN, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14335 SW 120TH ST | ||||||||
| Address2: | 201 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331867294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059678074 | ||||||||
| FaxNumber: | 3059678302 | ||||||||
| Practice Location | |||||||||
| Address1: | 14335 SW 120TH ST | ||||||||
| Address2: | 201 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331867294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059678074 | ||||||||
| FaxNumber: | 3059678302 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2016 | ||||||||
| LastUpdateDate: | 06/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | ANSIN | ||||||||
| AuthorizedOfficialFirstName: | ANA | ||||||||
| AuthorizedOfficialMiddleName: | CAROLINA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 3059678074 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.