Provider Demographics
NPI:1174320709
Name:RICO NIETO, ROSA DELIA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:DELIA
Last Name:RICO NIETO
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 1:709 S ROYAL POINCIANA BLVD APT 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7334
Mailing Address - Country:US
Mailing Address - Phone:786-352-3986
Mailing Address - Fax:
Practice Address - Street 1:709 S ROYAL POINCIANA BLVD APT 206
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7334
Practice Address - Country:US
Practice Address - Phone:786-352-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician