Provider Demographics
NPI:1235628074
Name:RODRIGUEZ, YORDAN
Entity Type:Individual
Prefix:MR
First Name:YORDAN
Middle Name:
Last Name: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 1:2175 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3938
Mailing Address - Country:US
Mailing Address - Phone:954-578-7684
Mailing Address - Fax:954-578-7689
Practice Address - Street 1:2175 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3938
Practice Address - Country:US
Practice Address - Phone:954-578-7684
Practice Address - Fax:954-578-7689
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor