Provider Demographics
NPI:1003340589
Name:ESPINOSA RODRIGUEZ, MAURA PATRICIA
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:PATRICIA
Last Name:ESPINOSA RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 NW 7TH ST PH 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3694
Mailing Address - Country:US
Mailing Address - Phone:786-585-3841
Mailing Address - Fax:
Practice Address - Street 1:5085 NW 7TH ST PH 2
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3694
Practice Address - Country:US
Practice Address - Phone:786-585-3841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FLMH16066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst