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General NPI Number Information
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NPI Number | 1285398875
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Entity Type | Individual
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Provider Name | ERNESTO FERNANDEZ RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 18101 PEREGRINES PERCH PL UNIT 206
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City | LUTZ
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State | FL
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Zip | 33558-2780
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Country | US
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Telephone | 786-720-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 18101 PEREGRINES PERCH PL UNIT 206
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City | LUTZ
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State | FL
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Zip | 33558-2780
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Country | US
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Telephone | 786-720-4464
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-126132
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-71828
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License Number State | FL
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