Provider Demographics
NPI:1043865553
Name:MOLINA RODRIGUEZ, BELKIS HAYDEE (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:BELKIS
Middle Name:HAYDEE
Last Name:MOLINA RODRIGUEZ
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 NW 173RD DR APT 1905
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5519
Mailing Address - Country:US
Mailing Address - Phone:786-370-1067
Mailing Address - Fax:
Practice Address - Street 1:7010 NW 173RD DR APT 1905
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5519
Practice Address - Country:US
Practice Address - Phone:786-370-1067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-54357103K00000X, 103K00000X
FL-18-68197106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty