MEDICARE: ANDRES RODRIGUEZ TOMAS

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	1-25-86870	FL
2	106S00000X	Behavior Technician	RBT-23-279860	FL

General Provider Information

NPI Number	:	1730865916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES RODRIGUEZ TOMAS

Provider Business Mailing Address
First Line	:	5720 MANGO RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1852
Country	:	US
Telephone Number	:	561-859-2198
Fax Number	:

Provider Business Practice Location Address
First Line	:	5720 MANGO RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33413-1852
Country	:	US
Telephone Number	:	561-859-2198
Fax Number	:

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

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	01/05/2026

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Directions to “ ANDRES RODRIGUEZ TOMAS ” Practice Location

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