Provider Demographics
NPI:1558694257
Name:AGUILERA-RODRIGUEZ, MARIA ELENA (DEGREE OF BACHELOR)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELENA
Last Name:AGUILERA-RODRIGUEZ
Suffix:
Gender:F
Credentials:DEGREE OF BACHELOR
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ELENA
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8785 SW 165TH AVE SUITE 106D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193
Mailing Address - Country:US
Mailing Address - Phone:786-391-2935
Mailing Address - Fax:786-409-2019
Practice Address - Street 1:8785 SW 165TH AVE SUITE 106D
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193
Practice Address - Country:US
Practice Address - Phone:786-391-2935
Practice Address - Fax:786-409-2019
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-12
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist