Provider Demographics
NPI:1831674001
Name:RODRIGUEZ REYES, MARIA DE LOS A
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOS A
Last Name:RODRIGUEZ REYES
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 1:9061 SW 156TH ST # A101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1995
Mailing Address - Country:US
Mailing Address - Phone:787-241-8955
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 183RD ST STE 136
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6009
Practice Address - Country:US
Practice Address - Phone:786-654-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9428458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily