Provider Demographics
NPI:1275252165
Name:RODRIGUEZ, ENID (BA, TAC II)
Entity Type:Individual
Prefix:MISS
First Name:ENID
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BA, TAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 N PINE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-7152
Mailing Address - Country:US
Mailing Address - Phone:407-522-2144
Mailing Address - Fax:
Practice Address - Street 1:1033 N PINE HILLS RD STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7152
Practice Address - Country:US
Practice Address - Phone:407-522-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)