Individual
JESUS LOPEZ RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CBHCM
Contact information
Practice address
15924 SW 92ND AVE, PALMETTO BAY, FL 33157-1842
(305) 964-5824
(786) 452-1200
Mailing address
14681 SW 108TH ST, MIAMI, FL 33186-2962
(786) 343-5270
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CBHCM.0100503
FL
Other
Enumeration date
11/05/2024
Last updated
05/06/2025
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