Provider Demographics
NPI:1720867245
Name:SANTANA ORTIZ, JUAN (CRNA)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:
Last Name:SANTANA ORTIZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 SW 8TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2442
Mailing Address - Country:US
Mailing Address - Phone:305-262-6060
Mailing Address - Fax:
Practice Address - Street 1:5101 SW 8TH ST STE 201
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2442
Practice Address - Country:US
Practice Address - Phone:305-262-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4395390200000X
FLAPRN11029683367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program