Provider Demographics
NPI:1073149902
Name:RODRIGUEZ ESTRADA, ANA AURORA
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:AURORA
Last Name:RODRIGUEZ ESTRADA
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 1:5501 NW 7TH ST APT E106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3203
Mailing Address - Country:US
Mailing Address - Phone:786-647-1530
Mailing Address - Fax:
Practice Address - Street 1:5501 NW 7TH ST APT E106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3203
Practice Address - Country:US
Practice Address - Phone:786-647-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty