Healthcare Provider Details

I. General information

NPI: 1679150809
Provider Name (Legal Business Name): MRS. FELICIA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 PAULS DR STE 200
BRANDON FL
33511-4716
US

IV. Provider business mailing address

356 SE 125TH PL
OCALA FL
34480-8568
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-4166
  • Fax:
Mailing address:
  • Phone: 800-356-4049
  • Fax: 727-377-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-159867
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: