Provider Demographics
NPI:1346919529
Name:RODRIGUEZ HERNANDEZ, ANAYS
Entity Type:Individual
Prefix:
First Name:ANAYS
Middle Name:
Last Name:RODRIGUEZ HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7662 SW 152ND AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1127
Mailing Address - Country:US
Mailing Address - Phone:786-354-8450
Mailing Address - Fax:305-255-6205
Practice Address - Street 1:7662 SW 152ND AVE APT 13
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-1127
Practice Address - Country:US
Practice Address - Phone:786-354-8450
Practice Address - Fax:305-255-6205
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-118451106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician