MEDICARE: JORGE N RODRIGUEZ CBHCM

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1992651921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORGE N RODRIGUEZ CBHCM

Provider Business Mailing Address
First Line	:	1900 W 68TH ST APT E204
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4477
Country	:	US
Telephone Number	:	786-934-0746
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 W 68TH ST APT E204
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-4477
Country	:	US
Telephone Number	:	786-934-0746
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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