Provider Demographics
NPI:1346862380
Name:ROSALES HERNANDEZ, MARIA CECILIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA
Last Name:ROSALES HERNANDEZ
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 1:3201 TAYLOR ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2141
Mailing Address - Country:US
Mailing Address - Phone:651-447-9970
Mailing Address - Fax:
Practice Address - Street 1:3201 TAYLOR ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-2141
Practice Address - Country:US
Practice Address - Phone:651-447-9970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study