MEDICARE: MR. JOSEPH FRANCIA 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	106S00000X	Behavior Technician	15-7049-11373	NV

General Provider Information

NPI Number	:	1629457437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH FRANCIA RODRIGUEZ

Provider Business Mailing Address
First Line	:	2110 E FLAMINGO RD
Second Line	:	150
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5190
Country	:	US
Telephone Number	:	702-626-3395
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 E FLAMINGO RD
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5190
Country	:	US
Telephone Number	:	702-626-3395
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	02/10/2017

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