Provider Demographics
NPI:1659140333
Name:RODRIGUEZ HERRERA, CLAUDIA DEYANIRA (RBT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:DEYANIRA
Last Name:RODRIGUEZ HERRERA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8806
Mailing Address - Country:US
Mailing Address - Phone:813-324-7538
Mailing Address - Fax:813-324-7538
Practice Address - Street 1:902 W LUMSDEN RD STE 105
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8806
Practice Address - Country:US
Practice Address - Phone:786-600-5195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FLRBT-23-318423106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician