Healthcare Provider Details

I. General information

NPI: 1497367742
Provider Name (Legal Business Name): ANA MORENO CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5804 SUNSET DR STE 1
SOUTH MIAMI FL
33143-5279
US

IV. Provider business mailing address

827 MADRID ST
CORAL GABLES FL
33134-2263
US

V. Phone/Fax

Practice location:
  • Phone: 305-804-0151
  • Fax:
Mailing address:
  • Phone: 305-804-0151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANA M MORENO
Title or Position: PRESIDENT
Credential: LMHC, MCAP
Phone: 305-804-0151