Healthcare Provider Details

I. General information

NPI: 1285961276
Provider Name (Legal Business Name): ADOLFO L NUNEZ RODRIGUEZ SR. LMHC, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 10/28/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 W 76TH ST
HIALEAH FL
33016
US

IV. Provider business mailing address

5801 E 2ND AVE
HIALEAH FL
33013-1213
US

V. Phone/Fax

Practice location:
  • Phone: 786-773-3393
  • Fax: 786-773-3394
Mailing address:
  • Phone: 786-832-0166
  • Fax: 786-773-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-20-41288
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 10015
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: