Healthcare Provider Details

I. General information

NPI: 1265013528
Provider Name (Legal Business Name): MONICA RODRIGUEZ RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 45TH ST STE 304
WEST PALM BEACH FL
33407-2011
US

IV. Provider business mailing address

4706 CARVER ST
LAKE WORTH FL
33463-2226
US

V. Phone/Fax

Practice location:
  • Phone: 561-323-2552
  • Fax:
Mailing address:
  • Phone: 786-314-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88105
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: