Healthcare Provider Details

I. General information

NPI: 1396653242
Provider Name (Legal Business Name): ROSENNI RUBIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 NW 5TH ST STE 216
PLANTATION FL
33317-2120
US

IV. Provider business mailing address

5505 NW 7TH ST APT W106
MIAMI FL
33126-3205
US

V. Phone/Fax

Practice location:
  • Phone: 754-779-0656
  • Fax:
Mailing address:
  • Phone: 786-794-1681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1058318
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: