Healthcare Provider Details

I. General information

NPI: 1730968033
Provider Name (Legal Business Name): MARIA LAURA RODRIGUEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11651 ROYAL PALM BLVD APT 207
CORAL SPRINGS FL
33065-6931
US

IV. Provider business mailing address

904 HIGHLAND SQUARE DR NE APT 904
ATLANTA GA
30306-2295
US

V. Phone/Fax

Practice location:
  • Phone: 786-597-0550
  • Fax:
Mailing address:
  • Phone: 786-597-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2828277
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: