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General NPI Number Information
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NPI Number | 1669059556
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Entity Type | Individual
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Provider Name | LIDICE RODRIGUEZ CABRERA
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 2853 SW 38TH AVE
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City | MIAMI
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State | FL
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Zip | 33134-7343
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Country | US
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Telephone | 786-317-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 PONDELLA RD APT 301
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City | CAPE CORAL
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State | FL
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Zip | 33909-5152
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Country | US
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Telephone | 786-317-8121
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-21-11832
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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 | 1-21-54370
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License Number State | FL
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