Individual
JOSE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13835 SW 106TH TER, MIAMI, FL 33186-3136
(786) 657-4366
Mailing address
14311 SW 88TH ST APT 203, MIAMI, FL 33186-8076
(786) 657-4366
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
106E00000X
Assistant Behavior Analyst
Primary
0-21-12156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0454753
—
FL
Enumeration date
02/15/2021
Last updated
03/07/2022
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