Provider Demographics
NPI:1225654536
Name:TAMAYO RODRIGUEZ, ADONIS FRANCISCO
Entity Type:Individual
Prefix:
First Name:ADONIS
Middle Name:FRANCISCO
Last Name:TAMAYO RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10863 SW 88TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1227
Mailing Address - Country:US
Mailing Address - Phone:786-559-1095
Mailing Address - Fax:
Practice Address - Street 1:10863 SW 88TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1227
Practice Address - Country:US
Practice Address - Phone:786-559-1095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-122101106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician