Healthcare Provider Details

I. General information

NPI: 1326279910
Provider Name (Legal Business Name): JOSUE HERMENEGILDO RODRIGUEZ SLP, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 SW 1ST ST
MIAMI FL
33135-1602
US

IV. Provider business mailing address

4904 GUMWOOD AVE
MCALLEN TX
78501-5469
US

V. Phone/Fax

Practice location:
  • Phone: 786-530-7191
  • Fax: 786-530-7119
Mailing address:
  • Phone: 956-655-3614
  • Fax: 305-675-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA23161
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2417
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: