Provider Demographics
NPI:1215266234
Name:ALTAMIRANDA, ROSINA ESTHER (MH11013)
Entity type:Individual
Prefix:MRS
First Name:ROSINA
Middle Name:ESTHER
Last Name:ALTAMIRANDA
Suffix:
Gender:F
Credentials:MH11013
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 S DIXIE HWY STE 215
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4449
Mailing Address - Country:US
Mailing Address - Phone:786-718-3890
Mailing Address - Fax:305-238-3511
Practice Address - Street 1:11921 S DIXIE HWY STE 215
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:786-718-3890
Practice Address - Fax:305-238-3511
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health