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General NPI Number Information
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NPI Number | 1699127084
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Entity Type | Individual
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Provider Name | LOURDES RODRIGUEZ-VEGA BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/08/2016
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 1317 EDGEWATER DR STE 2560
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 321-210-9741
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Fax | 321-256-5545
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Provider Business Mailing Address
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Address Line | 1317 EDGEWATER DR STE 2560
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 212-210-9741
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Fax | 321-256-5545
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-17-26673
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License Number State | FL
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