Provider Demographics
NPI:1588239214
Name:RODRIGUEZ FERNANDEZ, OLGA LIDIA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:LIDIA
Last Name:RODRIGUEZ FERNANDEZ
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 1:825 HELENA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3138
Mailing Address - Country:US
Mailing Address - Phone:561-644-3488
Mailing Address - Fax:
Practice Address - Street 1:420 SR-7 N
Practice Address - Street 2:SUITE 174
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-667-2181
Practice Address - Fax:561-247-7860
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician