MEDICARE: ADA 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	101YM0800X	Mental Health Counselor		FL

General Provider Information

NPI Number	:	1891393583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADA RODRIGUEZ

Provider Business Mailing Address
First Line	:	1218 MILLENNIUM PKWY STE 218
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-3895
Country	:	US
Telephone Number	:	813-407-3679
Fax Number	:

Provider Business Practice Location Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

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

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	05/19/2026

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Directions to “ ADA RODRIGUEZ ” Practice Location

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