MEDICARE: MELANIE 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
1	106S00000X	Behavior Technician	23-298660	FL

General Provider Information

NPI Number	:	1871372656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE M RODRIGUEZ

Provider Business Mailing Address
First Line	:	11321 SW 160TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-4285
Country	:	US
Telephone Number	:	786-440-3750
Fax Number	:

Provider Business Practice Location Address
First Line	:	11321 SW 160TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33196-4285
Country	:	US
Telephone Number	:	786-440-3750
Fax Number	:

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

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/21/2023

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Directions to “ MELANIE M RODRIGUEZ ” Practice Location

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