Provider Demographics
NPI:1639923576
Name:RODRIGUEZ LEAL, BARBARO FRANCISCO
Entity Type:Individual
Prefix:
First Name:BARBARO
Middle Name:FRANCISCO
Last Name:RODRIGUEZ LEAL
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 1:6150 SW 130TH AVE APT 1508
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5232
Mailing Address - Country:US
Mailing Address - Phone:786-710-5838
Mailing Address - Fax:
Practice Address - Street 1:6150 SW 130TH AVE APT 1508
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5232
Practice Address - Country:US
Practice Address - Phone:786-710-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM.0106506-P171M00000X
FLRBT-24-333476106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator