MEDICARE: CARIDAD RODRIGUEZ REINA

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	103K00000X	Behavior Analyst	1-21-54802	FL
2	106E00000X	Assistant Behavior Analyst	0-19-9769	FL
3	106S00000X	Behavior Technician	RBT-18-67680	FL
4	171M00000X	Case Manager/Care Coordinator

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	:	1578011292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARIDAD RODRIGUEZ REINA

Provider Business Mailing Address
First Line	:	10700 SW 46TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4839
Country	:	US
Telephone Number	:	786-907-4925
Fax Number	:	786-907-4972

Provider Business Practice Location Address
First Line	:	10700 SW 46TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4839
Country	:	US
Telephone Number	:	786-907-4925
Fax Number	:	786-907-4972

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

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	01/23/2025

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Directions to “ CARIDAD RODRIGUEZ REINA ” Practice Location

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