Provider Demographics
NPI:1922852318
Name:ROCHA ACOSTA, ARIEL ADOLFO
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:ADOLFO
Last Name:ROCHA ACOSTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15340 LEISURE DR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-2536
Mailing Address - Country:US
Mailing Address - Phone:786-572-8226
Mailing Address - Fax:
Practice Address - Street 1:15340 LEISURE DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-2536
Practice Address - Country:US
Practice Address - Phone:786-572-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician