Healthcare Provider Details

I. General information

NPI: 1144995671
Provider Name (Legal Business Name): REBECA GARCIA-RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 NW 12TH ST
DORAL FL
33126-1829
US

IV. Provider business mailing address

904 NW 22ND PL
MIAMI FL
33125-3319
US

V. Phone/Fax

Practice location:
  • Phone: 305-224-1929
  • Fax:
Mailing address:
  • Phone: 786-488-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-178275
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: