Provider Demographics
NPI:1417391731
Name:RODRIGUEZ, FRANK R SR (MS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:R
Last Name:RODRIGUEZ
Suffix:SR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N. SEMORAN BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3561
Mailing Address - Country:US
Mailing Address - Phone:407-704-7811
Mailing Address - Fax:407-382-0659
Practice Address - Street 1:1320 N. SEMORAN BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3561
Practice Address - Country:US
Practice Address - Phone:407-704-7811
Practice Address - Fax:407-382-0659
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health