Healthcare Provider Details

I. General information

NPI: 1205632692
Provider Name (Legal Business Name): MARIA DE LOS ANGELES RODRIGUEZ ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 NW 82ND AVE STE 202
DORAL FL
33166-6652
US

IV. Provider business mailing address

9120 SW 150TH AVE
MIAMI FL
33196-1496
US

V. Phone/Fax

Practice location:
  • Phone: 786-953-8845
  • Fax:
Mailing address:
  • Phone: 786-674-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-411783
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: