Provider Demographics
NPI:1336970995
Name:ROCIBELLA LLC
Entity type:Organization
Organization Name:ROCIBELLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMT/NP
Authorized Official - Prefix:
Authorized Official - First Name:YISEL
Authorized Official - Middle Name:MARCELINA
Authorized Official - Last Name:AGUILA DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:305-766-3819
Mailing Address - Street 1:7805 SW 24TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6539
Mailing Address - Country:US
Mailing Address - Phone:786-547-3549
Mailing Address - Fax:
Practice Address - Street 1:7805 SW 24TH ST STE 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6539
Practice Address - Country:US
Practice Address - Phone:786-547-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care