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General NPI Number Information
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NPI Number | 1083441208
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Entity Type | Organization
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Legal Business Name | SANTANA MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 09/19/2024
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 5901 SW 74TH ST STE 211
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5150
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Country | US
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Telephone | 786-228-6892
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Fax | 786-414-3622
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Provider Business Mailing Address
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Address Line | 5901 SW 74TH ST STE 211
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5150
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Country | US
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Telephone | 786-228-6892
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Fax | 786-414-3622
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Authorized Official
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Title or Position | PMHNP
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Name | LISNEY RODRIGUEZ GUTIERREZ
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Credential | PMHNP
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Telephone | 786-228-6892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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