Individual
DR. IVAN GABRIEL RODRIGUEZ
Active
Individual
DR. IVAN GABRIEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY11209
FL
103T00000X
Psychologist
41032
TX
103TC0700X
Clinical Psychologist
PY11209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A3858
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/03/2019
Last updated
08/20/2026
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