Provider Demographics
NPI:1851940183
Name:MORALES ESTEVEZ, ROSA T
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:T
Last Name:MORALES ESTEVEZ
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 1:5130 W FLAGLER ST APT 12
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1280
Mailing Address - Country:US
Mailing Address - Phone:786-718-4535
Mailing Address - Fax:
Practice Address - Street 1:5130 W FLAGLER ST APT 12
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1280
Practice Address - Country:US
Practice Address - Phone:786-718-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-19-91722106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician