Healthcare Provider Details

I. General information

NPI: 1073270179
Provider Name (Legal Business Name): ROSIRENEE QUESADA RODRIGUEZ CBHCMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST STE 727
HIALEAH FL
33012-2973
US

IV. Provider business mailing address

1950 W 54TH ST APT 418
HIALEAH FL
33012-2114
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-3086
  • Fax:
Mailing address:
  • Phone: 786-715-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM-P101981
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCBHCM-P101981
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29288
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCBHCMS0102613
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: