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NPI Code Detail

MEDICARE: MS. MAYRA RODRIGUEZ

MEDICARE: MS. MAYRA RODRIGUEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1215821269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAYRA RODRIGUEZ
Provider Business Mailing Address
First Line : 171 BRANDYWOOD ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-5847
Country : US
Telephone Number : 619-865-2297
Fax Number :
Provider Business Practice Location Address
First Line : 350 FAIRWAY DR
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33441-1834
Country : US
Telephone Number : 888-880-9270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2025
Last Update Date : 02/23/2026

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Directions to “ MS. MAYRA RODRIGUEZ ” Practice Location

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