Provider Demographics
NPI:1043231681
Name:DIAZ, ROSA MARIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ROSA MARIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3199 S OCEAN DR
Mailing Address - Street 2:503E
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7229
Mailing Address - Country:US
Mailing Address - Phone:954-458-0918
Mailing Address - Fax:
Practice Address - Street 1:1000 PARK CENTRE BLVD
Practice Address - Street 2:138
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-5373
Practice Address - Country:US
Practice Address - Phone:786-466-2900
Practice Address - Fax:786-466-2928
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1810106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist