MEDICARE: DANIELLE 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
1	2355S0801X	Speech-Language Assistant	SI3335	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1356835649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE RODRIGUEZ

Provider Business Mailing Address
First Line	:	12471 SW 76TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3522
Country	:	US
Telephone Number	:	786-395-6567
Fax Number	:

Provider Business Practice Location Address
First Line	:	12448 SW 127TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-6596
Country	:	US
Telephone Number	:	305-255-5980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	06/19/2018

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Directions to “ DANIELLE RODRIGUEZ ” Practice Location

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