Healthcare Provider Details

I. General information

NPI: 1003710948
Provider Name (Legal Business Name): MS. YANET NARIO RODRIGUEZ LEON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12347 SW 132ND CT
MIAMI FL
33186-6452
US

IV. Provider business mailing address

15318 SW 123RD AVE
MIAMI FL
33177-6802
US

V. Phone/Fax

Practice location:
  • Phone: 305-974-5686
  • Fax: 786-868-0551
Mailing address:
  • Phone: 786-283-9152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-26-2855153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: