Organization
BLUE ANGEL PROFESSIONAL CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO RODRIGUEZ RBT, RN (CEO)
(305) 220-6060
Entity
Organization
Contact information
Practice address
11890 SW 8TH ST STE 309, MIAMI, FL 33184-1710
(305) 220-6060
Mailing address
11890 SW 8TH ST STE 309, MIAMI, FL 33184-1710
(305) 220-6060
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017450400
—
FL
Enumeration date
10/15/2018
Last updated
11/19/2024
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