Provider Demographics
NPI:1003290735
Name:ROCHA, MARIA CAMILA (MS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CAMILA
Last Name:ROCHA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2557 CENTERGATE DR
Mailing Address - Street 2:#201
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7268
Mailing Address - Country:US
Mailing Address - Phone:786-223-2098
Mailing Address - Fax:
Practice Address - Street 1:2557 CENTERGATE DR
Practice Address - Street 2:#201
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7268
Practice Address - Country:US
Practice Address - Phone:786-223-2098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH12168171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator