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General NPI Number Information
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NPI Number | 1619897519
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Entity Type | Organization
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Legal Business Name | CASA SPROUT LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 5430 POLK ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6430
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Country | US
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Telephone | 305-333-3268
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Fax |
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Provider Business Mailing Address
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Address Line | 5430 POLK ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6430
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Country | US
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Telephone | 305-333-3268
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | OLGA L RODRIGUEZ
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Credential | LMHC
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Telephone | 305-333-3268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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