Provider Demographics
NPI:1467852541
Name:RODRIGUEZ, GEISHA (MBA)
Entity Type:Individual
Prefix:
First Name:GEISHA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9346 WATCHET WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3789
Mailing Address - Country:US
Mailing Address - Phone:787-407-2257
Mailing Address - Fax:
Practice Address - Street 1:9346 WATCHET WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3789
Practice Address - Country:US
Practice Address - Phone:787-407-2257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker