Provider Demographics
NPI:1326422031
Name:ADRIANZA, MARIA ROSARIO
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSARIO
Last Name:ADRIANZA
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 1:13108 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3101
Mailing Address - Country:US
Mailing Address - Phone:786-501-4569
Mailing Address - Fax:
Practice Address - Street 1:13108 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3101
Practice Address - Country:US
Practice Address - Phone:786-501-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20141015714363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical