Healthcare Provider Details

I. General information

NPI: 1952640021
Provider Name (Legal Business Name): DUVIEL RODRIGUEZ PHD., LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2013
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10570 S US HIGHWAY 1 STE 300
PORT SAINT LUCIE FL
34952-5606
US

IV. Provider business mailing address

5803 NW TREE HOUSE CT
PORT SAINT LUCIE FL
34986-4187
US

V. Phone/Fax

Practice location:
  • Phone: 772-233-6295
  • Fax: 772-607-6701
Mailing address:
  • Phone: 772-233-6295
  • Fax: 772-607-6701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: