Provider Demographics
NPI:1598258568
Name:ROSALES, ADOLFO M (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:ADOLFO
Middle Name:M
Last Name:ROSALES
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11195 SW 74TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4517
Mailing Address - Country:US
Mailing Address - Phone:305-450-8080
Mailing Address - Fax:
Practice Address - Street 1:301 ALMERIA AVE STE 220
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5822
Practice Address - Country:US
Practice Address - Phone:305-450-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health