Individual provider Active NPI

Alvin Rafael Santa-Ana

  • Developmental Therapist
  • Bradenton, FL
National Provider Identifier
1184765570
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
203 Sherwood Dr
Bradenton, FL 34210-4516
Phone
(786) 499-3789
Fax
(786) 499-3789
NPI assigned
Feb 9, 2007
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

203 Sherwood Dr
Bradenton, FL 34210-4516

Mailing address

203 Sherwood Dr
Bradenton, FL 34210-4516
Phone (786) 499-3789

Other identifiers 2

IdentifierTypeStateIssuer
1184765570OtherFLNPI NUMBER
001982000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1184765570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 SHERWOOD DR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342104516",
            "telephone_number": "786-499-3789",
            "fax_number": "786-499-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 SHERWOOD DR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342104516",
            "telephone_number": "786-499-3789",
            "fax_number": "786-499-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTA-ANA",
        "first_name": "ALVIN",
        "middle_name": "RAFAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1184765570",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001982000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.