Provider Demographics
NPI:1467166231
Name:RODRIGUEZ, JOSUE D (BA)
Entity Type:Individual
Prefix:
First Name:JOSUE
Middle Name:D
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1802
Mailing Address - Country:US
Mailing Address - Phone:786-451-3040
Mailing Address - Fax:
Practice Address - Street 1:2103 CORAL WAY STE 603
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2656
Practice Address - Country:US
Practice Address - Phone:786-464-0353
Practice Address - Fax:786-483-8142
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No253Z00000XAgenciesIn Home Supportive Care