Healthcare Provider Details

I. General information

NPI: 1437648938
Provider Name (Legal Business Name): LISANDRA BARBARA RODRIGUEZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9408 SW 87TH AVE STE 102
MIAMI FL
33176-2416
US

IV. Provider business mailing address

9408 SW 87TH AVE STE 102
MIAMI FL
33176-2416
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax: 786-220-1565
Mailing address:
  • Phone: 833-769-3524
  • Fax: 786-220-1565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH26783
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: