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NPI Code Detail

MEDICARE: ERNESTO FERNANDEZ RODRIGUEZ

MEDICARE: ERNESTO FERNANDEZ 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 TechnicianRBT-20-126132FL
2103K00000XBehavior Analyst1-24-71828FL

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 : 1285398875
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERNESTO FERNANDEZ RODRIGUEZ
Provider Business Mailing Address
First Line : 18101 PEREGRINES PERCH PL UNIT 206
Second Line :
City : LUTZ
State : FL
Zip : 33558-2780
Country : US
Telephone Number : 786-720-4464
Fax Number :
Provider Business Practice Location Address
First Line : 5051 MEMORIAL HWY UNIT B
Second Line :
City : TAMPA
State : FL
Zip : 33634-7355
Country : US
Telephone Number : 786-395-8225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2021
Last Update Date : 03/09/2026

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Directions to “ ERNESTO FERNANDEZ RODRIGUEZ ” Practice Location

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