Individual
ROGELIO GONZALEZ DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23037 SW 108TH CT, MIAMI, FL 33170-7538
(786) 302-0569
Mailing address
23037 SW 108TH CT, MIAMI, FL 33170-7538
(786) 302-0569
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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