Healthcare Provider Details

I. General information

NPI: 1659930410
Provider Name (Legal Business Name): TAYMI CANOVAS RODRIGUEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 06/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 NW 17TH ST
MIAMI FL
33125-1949
US

IV. Provider business mailing address

3070 NW 17TH ST
MIAMI FL
33125-1949
US

V. Phone/Fax

Practice location:
  • Phone: 786-334-3528
  • Fax:
Mailing address:
  • Phone: 786-334-3528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: