Provider Demographics
NPI:1235238833
Name:CARTAYA, ROSA MARIA (MA)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:CARTAYA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14614 SW 143RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7204
Mailing Address - Country:US
Mailing Address - Phone:305-972-9530
Mailing Address - Fax:305-255-7760
Practice Address - Street 1:6401 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2500
Practice Address - Country:US
Practice Address - Phone:305-972-9530
Practice Address - Fax:305-255-7760
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10094101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002341200Medicaid