Provider Demographics
NPI:1396832861
Name:RIGOL, ROSA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:MARIA
Last Name:RIGOL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PONCE DELEON BLVD
Mailing Address - Street 2:SUITE #310
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-720-7520
Mailing Address - Fax:305-740-4628
Practice Address - Street 1:4601 PONCE DELEON BLVD
Practice Address - Street 2:SUITE #310
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146
Practice Address - Country:US
Practice Address - Phone:305-720-7520
Practice Address - Fax:305-740-4628
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6179103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54737Medicare ID - Type UnspecifiedPROVIDER NUMBER