Provider Demographics
NPI:1609535103
Name:CHEDIAK ROJAS, ROSA MARIA (RBT)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:CHEDIAK ROJAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2729 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3323
Mailing Address - Country:US
Mailing Address - Phone:786-873-0181
Mailing Address - Fax:
Practice Address - Street 1:10300 SW 72ND ST STE 333
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3019
Practice Address - Country:US
Practice Address - Phone:305-279-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-146323106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician