Healthcare Provider Details

I. General information

NPI: 1326764937
Provider Name (Legal Business Name): JANINE SANCHES RODRIGUES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 POINCIANA PL APT 316
DAVIE FL
33324-4858
US

IV. Provider business mailing address

9430 POINCIANA PL APT 316
DAVIE FL
33324-4858
US

V. Phone/Fax

Practice location:
  • Phone: 754-367-2765
  • Fax: 754-315-2683
Mailing address:
  • Phone: 754-367-2765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: