MEDICARE: NATASHA MIA SANTANA-VIERA MSW, RCSWI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	12755	FL

General Provider Information

NPI Number	:	1487397220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA MIA SANTANA-VIERA MSW, RCSWI

Provider Business Mailing Address
First Line	:	468 NW 207TH ST APT 305
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-2596
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	468 NW 207TH ST APT 305
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-2596
Country	:	US
Telephone Number	:	786-228-6307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2022
Last Update Date	:	04/19/2022

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