Provider Demographics
NPI:1972045391
Name:CID ROJAS, MARIBEL
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:CID ROJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIBEL
Other - Middle Name:
Other - Last Name:CID ROJAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MT
Mailing Address - Street 1:8040 NW 95TH ST APT 220
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2361
Mailing Address - Country:US
Mailing Address - Phone:305-456-6340
Mailing Address - Fax:786-464-0441
Practice Address - Street 1:8040 NW 95TH ST APT 220
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-2361
Practice Address - Country:US
Practice Address - Phone:305-456-6340
Practice Address - Fax:786-464-0441
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT67974225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMT67974OtherPROFESSIONAL LICENSE