Healthcare Provider Details

I. General information

NPI: 1750246260
Provider Name (Legal Business Name): VALERIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 77TH CT E
PALMETTO FL
34221-2588
US

IV. Provider business mailing address

3401 19TH ST W
BRADENTON FL
34205-5525
US

V. Phone/Fax

Practice location:
  • Phone: 941-218-0727
  • Fax: 941-761-5945
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-499350
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: