Provider Demographics
NPI:1609569771
Name:GARCIA RODRIGUEZ, DANIEL RENE
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RENE
Last Name:GARCIA RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21221 SW 125TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5786
Mailing Address - Country:US
Mailing Address - Phone:786-580-9960
Mailing Address - Fax:
Practice Address - Street 1:2141 SW 1ST ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1695
Practice Address - Country:US
Practice Address - Phone:305-644-6024
Practice Address - Fax:305-644-6025
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician