Provider Demographics
NPI:1144750803
Name:RODRIGUEZ MASO, ANA MARGARITA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARGARITA
Last Name:RODRIGUEZ MASO
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 1:2100 SANS SOUCI BLVD APT 608
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3024
Mailing Address - Country:US
Mailing Address - Phone:305-395-0655
Mailing Address - Fax:
Practice Address - Street 1:2100 SANS SOUCI BLVD APT 608
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3024
Practice Address - Country:US
Practice Address - Phone:305-395-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021267000Medicaid