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Individual

AMY RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4544
Mailing address
910 N JEFFERSON ST, JACKSONVILLE, FL 32209-6810
(904) 360-7022
(904) 798-4544

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
222Q00000X
Developmental Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000609700
FL
05
811668700
FL
Enumeration date
01/04/2007
Last updated
03/25/2011
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