Individual
MICHAEL ALEXANDER RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
9131 COLLEGE POINTE CT, FORT MYERS, FL 33919-3245
(239) 343-9100
(239) 343-9108
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9100
(239) 343-9108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY11194
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111405100
—
FL
Enumeration date
07/23/2021
Last updated
11/10/2021
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