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NPI Code Detail

MEDICARE: ANYENI RODRIGUEZ LEAL

MEDICARE: ANYENI RODRIGUEZ LEAL
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 TechnicianRBT-23-296492FL

General Provider Information

NPI Number : 1881425023
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANYENI RODRIGUEZ LEAL
Provider Business Mailing Address
First Line : 233 S LAKE DR
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-7054
Country : US
Telephone Number : 239-922-4142
Fax Number :
Provider Business Practice Location Address
First Line : 3351 MARINATOWN LN STE 200
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-7000
Country : US
Telephone Number : 239-747-3996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2024
Last Update Date : 08/09/2024

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Directions to “ ANYENI RODRIGUEZ LEAL ” Practice Location

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