Provider Demographics
NPI:1124216858
Name:VALCOURT-RODRIGUEZ, MARIA L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:VALCOURT-RODRIGUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 COW PEN RD STE 250
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7622
Mailing Address - Country:US
Mailing Address - Phone:305-764-0194
Mailing Address - Fax:786-513-7733
Practice Address - Street 1:6600 COW PEN RD STE 250
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-7622
Practice Address - Country:US
Practice Address - Phone:305-764-0194
Practice Address - Fax:786-513-7733
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7537103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical