Provider Demographics
NPI:1508331034
Name:CARRANZA, ROSA MARIA I
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:CARRANZA
Suffix:I
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 1:1119 OBISPO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3557
Mailing Address - Country:US
Mailing Address - Phone:305-495-1144
Mailing Address - Fax:
Practice Address - Street 1:1119 OBISPO AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3557
Practice Address - Country:US
Practice Address - Phone:305-495-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty