Provider Demographics
NPI:1629892864
Name:ROCHA, AMNERIS
Entity type:Individual
Prefix:
First Name:AMNERIS
Middle Name:
Last Name:ROCHA
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 1:171 NW 97TH AVE APT 114
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4149
Mailing Address - Country:US
Mailing Address - Phone:786-638-9203
Mailing Address - Fax:
Practice Address - Street 1:171 NW 97TH AVE APT 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4149
Practice Address - Country:US
Practice Address - Phone:786-638-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-388113106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician