MEDICARE: IVETTE RODRIGUEZ BPS, MBA, CAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1316558703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVETTE RODRIGUEZ BPS, MBA, CAP

Provider Business Mailing Address
First Line	:	651 W WARREN AVE
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4036
Country	:	US
Telephone Number	:	321-999-9614
Fax Number	:

Provider Business Practice Location Address
First Line	:	651 W WARREN AVE
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4036
Country	:	US
Telephone Number	:	321-999-9614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	09/04/2025

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