Individual
LISSETTE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13700 SW 114TH PL, DUNNELLON, FL 34432-5323
(352) 465-6908
(352) 465-6908
Mailing address
13700 SW 114TH PL, DUNNELLON, FL 34432-5323
(352) 465-6908
(352) 465-6908
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690821796
—
FL
05
—
690821798
—
FL
Enumeration date
11/10/2010
Last updated
11/10/2010
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