Provider Demographics
NPI:1245600345
Name:RODRIGUEZ MARTINEZ, YOLAIDYS (RBT)
Entity Type:Individual
Prefix:
First Name:YOLAIDYS
Middle Name:
Last Name:RODRIGUEZ MARTINEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7721
Mailing Address - Country:US
Mailing Address - Phone:407-340-8127
Mailing Address - Fax:
Practice Address - Street 1:1020 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7721
Practice Address - Country:US
Practice Address - Phone:407-340-8127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18-56191106S00000X
FLCBHCM101530171M00000X
FL140393246ZS0410X
FL21-505246ZC0007X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist