Provider Demographics
NPI:1073113924
Name:RODRIGUEZ FERRAZ, NELSON M
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:M
Last Name:RODRIGUEZ FERRAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15241 SW 80TH ST APT 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1336
Mailing Address - Country:US
Mailing Address - Phone:786-378-2031
Mailing Address - Fax:
Practice Address - Street 1:5040 NW 7TH ST STE 685
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3432
Practice Address - Country:US
Practice Address - Phone:786-695-8672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty