Healthcare Provider Details

I. General information

NPI: 1689536070
Provider Name (Legal Business Name): AMELIA LLERENA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 FOREST HILL BLVD STE 109
WEST PALM BEACH FL
33406-5941
US

IV. Provider business mailing address

94 HENTHORNE DR
LAKE WORTH FL
33461-2918
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-5050
  • Fax: 561-354-6027
Mailing address:
  • Phone: 786-400-6912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: