Healthcare Provider Details

I. General information

NPI: 1821561028
Provider Name (Legal Business Name): DANAY RODRIGUEZ LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17650 SW 46TH ST
MIRAMAR FL
33029-2788
US

IV. Provider business mailing address

3075 NW 7TH ST APT 202
MIAMI FL
33125-4245
US

V. Phone/Fax

Practice location:
  • Phone: 786-616-3820
  • Fax:
Mailing address:
  • Phone: 786-616-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2828638
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: