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NPI Code Detail

MEDICARE: RAFAEL RODRIGUEZ SR. MSW

MEDICARE: RAFAEL RODRIGUEZ SR. MSW
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
1101YM0800XMental Health Counselor

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 : 1437578531
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAFAEL RODRIGUEZ SR. MSW
Provider Business Mailing Address
First Line : 920 NW 7 AVENUE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311
Country : US
Telephone Number : 954-779-3990
Fax Number :
Provider Business Practice Location Address
First Line : 920 NW 7TH AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33311-7229
Country : US
Telephone Number : 954-779-3990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 04/16/2014

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