Healthcare Provider Details

I. General information

NPI: 1962101865
Provider Name (Legal Business Name): MARIA DOLORES RODRIGUEZ BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1793 SW 5TH ST APT 200
MIAMI FL
33135-3517
US

IV. Provider business mailing address

1793 SW 5TH ST APT 200
MIAMI FL
33135-3517
US

V. Phone/Fax

Practice location:
  • Phone: 305-298-4728
  • Fax:
Mailing address:
  • Phone: 305-298-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBCABA0-26-16783
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-258812
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: