Provider Demographics
NPI:1003674763
Name:RODRIGUEZ ESPINOSA, YELINE
Entity Type:Individual
Prefix:
First Name:YELINE
Middle Name:
Last Name:RODRIGUEZ ESPINOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 SW 175TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6667
Mailing Address - Country:US
Mailing Address - Phone:786-781-8694
Mailing Address - Fax:
Practice Address - Street 1:14300 SW 175TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6667
Practice Address - Country:US
Practice Address - Phone:786-781-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-325730106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician