Healthcare Provider Details

I. General information

NPI: 1821920794
Provider Name (Legal Business Name): JAZMIN MARIE RODRIGUEZ ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17121 NE 6TH AVE
NORTH MIAMI BEACH FL
33162-2008
US

IV. Provider business mailing address

17121 NE 6TH AVE
NORTH MIAMI BEACH FL
33162-2008
US

V. Phone/Fax

Practice location:
  • Phone: 305-952-3161
  • Fax:
Mailing address:
  • Phone: 305-952-3161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-509661
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: