Provider Demographics
NPI:1639294754
Name:HERRERA, ANA MARIA (PTA)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 ANTIQUERA AVE
Mailing Address - Street 2:APT. 204
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2962
Mailing Address - Country:US
Mailing Address - Phone:786-346-0130
Mailing Address - Fax:
Practice Address - Street 1:227 ANTIQUERA AVE
Practice Address - Street 2:APT. 204
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2962
Practice Address - Country:US
Practice Address - Phone:786-346-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20828174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist