Provider Demographics
NPI:1376054130
Name:CANET RIOS, ROSMEILIN
Entity Type:Individual
Prefix:
First Name:ROSMEILIN
Middle Name:
Last Name:CANET RIOS
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 1:10451 W OKEECHOBEE RD APT 307
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1941
Mailing Address - Country:US
Mailing Address - Phone:053-458-1165
Mailing Address - Fax:
Practice Address - Street 1:10451 W OKEECHOBEE RD APT 307
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1941
Practice Address - Country:US
Practice Address - Phone:305-458-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-119835106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician