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Individual

ALEXIS GARCIA RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
901 SW 115TH AVE, PEMBROKE PINES, FL 33025-4316
(786) 424-6514
Mailing address
17710 NW 67TH AVE APT 308, HIALEAH, FL 33015-5808
(786) 424-6514

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-76092
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102874300
FL
Enumeration date
09/25/2018
Last updated
12/06/2023
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