MEDICARE: MRS. LILYANA RODRIGUEZ

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	104100000X	Social Worker
2	222Q00000X	Developmental Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649362427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILYANA RODRIGUEZ

Provider Business Mailing Address
First Line	:	11440 N KENDALL DR STE 109
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1024
Country	:	US
Telephone Number	:	305-929-8705
Fax Number	:	305-600-3714

Provider Business Practice Location Address
First Line	:	11440 N KENDALL DR STE 109
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-1024
Country	:	US
Telephone Number	:	305-929-8705
Fax Number	:	305-600-3714

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

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	02/04/2021

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Directions to “ MRS. LILYANA RODRIGUEZ ” Practice Location

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