Healthcare Provider Details

I. General information

NPI: 1497916100
Provider Name (Legal Business Name): ARMINDA RODRIGUEZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2804 W MARC KNIGHTON CT STE A
LECANTO FL
34461-6301
US

IV. Provider business mailing address

5101 SW 60TH STREET RD APT. 3504
OCALA FL
34474-5793
US

V. Phone/Fax

Practice location:
  • Phone: 352-746-8000
  • Fax:
Mailing address:
  • Phone: 786-877-5143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 8872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: