Provider Demographics
NPI:1417672791
Name:RODRIGUEZ, JANI (PHD)
Entity Type:Individual
Prefix:
First Name:JANI
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 W 22ND CT APT 206
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3988
Mailing Address - Country:US
Mailing Address - Phone:786-356-5220
Mailing Address - Fax:
Practice Address - Street 1:14247 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6408
Practice Address - Country:US
Practice Address - Phone:786-238-6031
Practice Address - Fax:786-817-2976
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling