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General NPI Number Information
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NPI Number | 1689358988
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Entity Type | Individual
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Provider Name | SANDY RODRIGUEZ CORREA
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Gender | Male
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 3012 E COMMERCIAL BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-4356
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Country | US
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Telephone | 954-776-9992
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Fax | 954-776-9993
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Provider Business Mailing Address
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Address Line | DEPT 394 PO BOX 1000
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City | MEMPHIS
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State | TN
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Zip | 38148-0001
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Country | US
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Telephone | 941-300-4440
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Fax | 941-404-1760
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH2593
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License Number State | FL
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