Healthcare Provider Details

I. General information

NPI: 1962786707
Provider Name (Legal Business Name): SANDRA SANTANA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA SANTANA PMHNP-BC

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 6381
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

7901 4TH ST N STE 6381
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 646-217-2120
  • Fax:
Mailing address:
  • Phone: 646-217-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1060335
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN738668
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR246375
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number253959
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number695018
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP023393
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN1060335
License Number StateDC
# 8
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11011278
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR246375
License Number StateMD
# 10
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: