Provider Demographics
NPI:1033961461
Name:RODRIGUEZ MESTRE, DAIMY
Entity Type:Individual
Prefix:
First Name:DAIMY
Middle Name:
Last Name:RODRIGUEZ MESTRE
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 1:6175 W 20TH AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7581
Mailing Address - Country:US
Mailing Address - Phone:786-454-5175
Mailing Address - Fax:
Practice Address - Street 1:6175 W 20TH AVE APT 308
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7581
Practice Address - Country:US
Practice Address - Phone:786-454-5175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-125258106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician