Provider Demographics
NPI:1730677600
Name:OROZCO RODRIGUEZ, MARITZA DE LA CARIDAD
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:DE LA CARIDAD
Last Name:OROZCO 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 1:175 FONTAINEBLEAU BLVD STE 2D1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-7013
Mailing Address - Country:US
Mailing Address - Phone:305-228-7000
Mailing Address - Fax:
Practice Address - Street 1:4160 W 16TH AVE STE 502
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5884
Practice Address - Country:US
Practice Address - Phone:786-401-7531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017588800Medicaid