Provider Demographics
NPI:1831674001
Name:RODRIGUEZ REYES, MARIA DE LOS A
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOS A
Last Name:RODRIGUEZ REYES
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 1:9350 SW 137TH AVE APT 509
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1404
Mailing Address - Country:US
Mailing Address - Phone:787-241-8955
Mailing Address - Fax:
Practice Address - Street 1:3501 SW 107TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3634
Practice Address - Country:US
Practice Address - Phone:786-238-7486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9428458363LF0000X
FLAPRN9428458363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily