Provider Demographics
NPI:1972274991
Name:MARRERO RIGAU, ANA LOURDES
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LOURDES
Last Name:MARRERO RIGAU
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 1:20750 SW 86TH PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3839
Mailing Address - Country:US
Mailing Address - Phone:786-273-8231
Mailing Address - Fax:
Practice Address - Street 1:7235 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1466
Practice Address - Country:US
Practice Address - Phone:786-452-0257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108281600Medicaid