Provider Demographics
NPI:1578263976
Name:ACOSTA SOLER, ROSA DELIA
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:DELIA
Last Name:ACOSTA SOLER
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 1:738 W 65TH DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6563
Mailing Address - Country:US
Mailing Address - Phone:786-326-2751
Mailing Address - Fax:
Practice Address - Street 1:738 W 65TH DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6563
Practice Address - Country:US
Practice Address - Phone:786-326-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT21153326106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician