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NPI Code Detail

MEDICARE: BLANCA SANTANDER

MEDICARE: BLANCA SANTANDER
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
1106S00000XBehavior Technician
2101YM0800XMental Health CounselorIMH23364FL

General Provider Information

NPI Number : 1801297635
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLANCA SANTANDER
Provider Business Mailing Address
First Line : 850 NE 121ST ST
Second Line :
City : BISCAYNE PARK
State : FL
Zip : 33161-6316
Country : US
Telephone Number : 786-571-0573
Fax Number :
Provider Business Practice Location Address
First Line : 2141 SW 1ST ST STE 103
Second Line :
City : MIAMI
State : FL
Zip : 33135-1695
Country : US
Telephone Number : 305-644-6024
Fax Number : 305-644-6025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2014
Last Update Date : 03/21/2023

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Directions to “ BLANCA SANTANDER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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