Healthcare Provider Details

I. General information

NPI: 1649183641
Provider Name (Legal Business Name): KATIANA M RODRIGUEZ RBT-26-2851237
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 NW 79TH AVE STE 246
DORAL FL
33166-6502
US

IV. Provider business mailing address

10721 SW 240TH TER
HOMESTEAD FL
33032-5182
US

V. Phone/Fax

Practice location:
  • Phone: 786-418-5400
  • Fax: 786-937-9375
Mailing address:
  • Phone: 305-877-5749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberRBT-26-2851237
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: