Healthcare Provider Details

I. General information

NPI: 1154256733
Provider Name (Legal Business Name): CHABELA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 55TH ST
HIALEAH FL
33013-1438
US

IV. Provider business mailing address

105 E 55TH ST
HIALEAH FL
33013-1438
US

V. Phone/Fax

Practice location:
  • Phone: 786-832-1126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberCBHCM.0105434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: