Provider Demographics
NPI:1568176964
Name:ESPINOSA RODRIGUEZ, MARIA ELENA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:ESPINOSA RODRIGUEZ
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 1:8850 CARIBBEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7101
Mailing Address - Country:US
Mailing Address - Phone:305-720-5320
Mailing Address - Fax:
Practice Address - Street 1:8850 CARIBBEAN BLVD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7101
Practice Address - Country:US
Practice Address - Phone:305-720-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician