Healthcare Provider Details

I. General information

NPI: 1437627122
Provider Name (Legal Business Name): LUSY RODRIGUEZ MAURI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 2ND ST SE
NAPLES FL
34117-9376
US

IV. Provider business mailing address

2945 40TH AVE SE
NAPLES FL
34117-7835
US

V. Phone/Fax

Practice location:
  • Phone: 786-682-1704
  • Fax:
Mailing address:
  • Phone: 786-682-1704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: