Provider Demographics
NPI:1598331506
Name:CLAUDIO RODRIGUEZ, ILEANA (MA,SLP)
Entity Type:Individual
Prefix:
First Name:ILEANA
Middle Name:
Last Name:CLAUDIO RODRIGUEZ
Suffix:
Gender:F
Credentials:MA,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BONNEVILLE VALLEY CRISTO REY
Mailing Address - Street 2:APT 26
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2441 NW 93RD AVE STE 105B
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-4800
Practice Address - Country:US
Practice Address - Phone:787-595-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist