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NPI Code Detail

MEDICARE: GRISSEL RODRIGUEZ

MEDICARE:   GRISSEL  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 Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245957901
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRISSEL RODRIGUEZ
Provider Business Mailing Address
First Line : 18611 HOLLISTER RD
Second Line :
City : ORLANDO
State : FL
Zip : 32820-2444
Country : US
Telephone Number : 787-466-9210
Fax Number :
Provider Business Practice Location Address
First Line : 730 SAND LAKE RD
Second Line :
City : ORLANDO
State : FL
Zip : 32809-7750
Country : US
Telephone Number : 407-412-6114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2022
Last Update Date : 11/02/2022

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Directions to “ GRISSEL RODRIGUEZ ” Practice Location

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