=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033341862
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUANN RODRIGUEZ PHD, LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2009
-----------------------------------------------------
Last Update Date | 11/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18901 SW 106TH AVE SUITE # A-108
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-7661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-283-4701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18901 SW 106TH AVE STE 108
-----------------------------------------------------
City | CUTLER BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-7658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-231-0910
-----------------------------------------------------
Fax | 786-231-1255
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MT 2335
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------