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NPI Code Detail

MEDICARE: LOURDES M RODRIGUEZ

MEDICARE: LOURDES M 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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RBT-16-24746OTHERFLREGISTER BEHAVIOR TECHNICIAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811463243
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOURDES M RODRIGUEZ
Provider Business Mailing Address
First Line : 13512 INLET LN APT 208
Second Line :
City : ORLANDO
State : FL
Zip : 32824-5102
Country : US
Telephone Number : 407-692-4170
Fax Number :
Provider Business Practice Location Address
First Line : 13512 INLET LN APT 208
Second Line :
City : ORLANDO
State : FL
Zip : 32824-5102
Country : US
Telephone Number : 407-692-4170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 10/24/2018

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Directions to “ LOURDES M RODRIGUEZ ” Practice Location

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