Healthcare Provider Details

I. General information

NPI: 1588312961
Provider Name (Legal Business Name): KEYSLIN RODRIGUEZ HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27833 SW 131ST AVE
HOMESTEAD FL
33032-8546
US

IV. Provider business mailing address

27833 SW 131ST AVE
HOMESTEAD FL
33032-8546
US

V. Phone/Fax

Practice location:
  • Phone: 786-217-3621
  • Fax:
Mailing address:
  • Phone: 786-217-3621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-25-86486
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: