Provider Demographics
NPI:1982461836
Name:RODRIGUEZ, MAYBET
Entity type:Individual
Prefix:
First Name:MAYBET
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 SW 200TH DR APT 166
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7673
Mailing Address - Country:US
Mailing Address - Phone:610-441-2456
Mailing Address - Fax:
Practice Address - Street 1:8900 SW 107TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1451
Practice Address - Country:US
Practice Address - Phone:786-401-6152
Practice Address - Fax:786-401-6155
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty