MEDICARE: SANDRA RODRIGUEZ MARTIN

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1710757141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA RODRIGUEZ MARTIN

Provider Business Mailing Address
First Line	:	2510 MILL RUN BLVD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-2766
Country	:	US
Telephone Number	:	786-578-3362
Fax Number	:

Provider Business Practice Location Address
First Line	:	7212 CURRY FORD RD BLDG 3
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5806
Country	:	US
Telephone Number	:	407-574-8481
Fax Number	:

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

Provider Enumeration Date	:	01/05/2024
Last Update Date	:	03/11/2026

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Directions to “ SANDRA RODRIGUEZ MARTIN ” Practice Location

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