Healthcare Provider Details

I. General information

NPI: 1497900583
Provider Name (Legal Business Name): LIUDY RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 BLUEBIRD AVE
MIAMI SPRINGS FL
33166-3229
US

IV. Provider business mailing address

1045 BLUEBIRD AVE
MIAMI SPRINGS FL
33166-3229
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-3425
  • Fax:
Mailing address:
  • Phone: 786-715-3425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number14920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: