Healthcare Provider Details

I. General information

NPI: 1205447133
Provider Name (Legal Business Name): ROSANGELA BARO DIAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 SW 5TH TER
CORAL GABLES FL
33134-1951
US

IV. Provider business mailing address

4310 SW 5TH TER
CORAL GABLES FL
33134-1951
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-1998
  • Fax:
Mailing address:
  • Phone: 786-502-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88706
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-121451
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: