Healthcare Provider Details

I. General information

NPI: 1891415436
Provider Name (Legal Business Name): JENNIFER RODRIGUEZ ABRANTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 SE PORT ST LUCIE BLVD
PORT ST LUCIE FL
34984-5108
US

IV. Provider business mailing address

1781 SW CINEMA ST
PORT ST LUCIE FL
34953-1063
US

V. Phone/Fax

Practice location:
  • Phone: 772-202-0173
  • Fax: 772-209-7631
Mailing address:
  • Phone: 786-554-2725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-91052
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-231331
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: