Provider Demographics
NPI:1326513227
Name:RODECK II INC.
Entity Type:Organization
Organization Name:RODECK II INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARGEO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-299-1543
Mailing Address - Street 1:9700 MONTEGO BAY DR.
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189
Mailing Address - Country:US
Mailing Address - Phone:786-299-1543
Mailing Address - Fax:
Practice Address - Street 1:25940 SW 132ND PL
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:FL
Practice Address - Zip Code:33032-6886
Practice Address - Country:US
Practice Address - Phone:786-299-1543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692-607-096Medicaid