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NPI Code Detail

MEDICARE: EVELYN MISBEL RODRIGUEZ

MEDICARE:   EVELYN MISBEL 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 TechnicianFL

General Provider Information

NPI Number : 1629849708
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVELYN MISBEL RODRIGUEZ
Provider Business Mailing Address
First Line : 1417 SE 12TH TER
Second Line :
City : CAPE CORAL
State : FL
Zip : 33990-3616
Country : US
Telephone Number : 786-458-4987
Fax Number :
Provider Business Practice Location Address
First Line : 1417 SE 12TH TER
Second Line :
City : CAPE CORAL
State : FL
Zip : 33990-3616
Country : US
Telephone Number : 786-458-4987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2024
Last Update Date : 01/09/2024

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Directions to “ EVELYN MISBEL RODRIGUEZ ” Practice Location

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