Provider Demographics
NPI:1326615048
Name:RODRIGUEZ, ANA ALEJANDRINA (BEHAVIOR TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ALEJANDRINA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 23RD ST SW
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33976-3313
Mailing Address - Country:US
Mailing Address - Phone:786-627-8767
Mailing Address - Fax:305-477-1120
Practice Address - Street 1:3720 23RD ST SW
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33976-3313
Practice Address - Country:US
Practice Address - Phone:786-627-8767
Practice Address - Fax:305-477-1120
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty