Provider Demographics
NPI:1598211344
Name:RODRIGUEZ, ANAIS (BS)
Entity Type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 W 36TH AVE
Mailing Address - Street 2:203
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2978
Mailing Address - Country:US
Mailing Address - Phone:786-720-0104
Mailing Address - Fax:
Practice Address - Street 1:6823 W 36TH AVE
Practice Address - Street 2:203
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2978
Practice Address - Country:US
Practice Address - Phone:786-720-0104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator