Provider Demographics
NPI:1326632381
Name:RODRIGUEZ, OSCAR III
Entity Type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:RODRIGUEZ
Suffix:III
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 1:14314 SW 285TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1743
Mailing Address - Country:US
Mailing Address - Phone:786-427-3735
Mailing Address - Fax:
Practice Address - Street 1:14314 SW 285TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1743
Practice Address - Country:US
Practice Address - Phone:786-427-3735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB649130106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician