Provider Demographics
NPI:1013688027
Name:ACOSTA RIGUAL, MARIANA GUADALUPE (BCABA)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:GUADALUPE
Last Name:ACOSTA RIGUAL
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9741 SW 216TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1166
Mailing Address - Country:US
Mailing Address - Phone:786-620-3051
Mailing Address - Fax:
Practice Address - Street 1:9741 SW 216TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1166
Practice Address - Country:US
Practice Address - Phone:786-620-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-106360106S00000X
FL0-22-14122106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty