Provider Demographics
NPI:1659156636
Name:RODRIGUEZ, YAUSELYS SR
Entity Type:Individual
Prefix:
First Name:YAUSELYS
Middle Name:
Last Name:RODRIGUEZ
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3417
Mailing Address - Country:US
Mailing Address - Phone:305-927-8764
Mailing Address - Fax:
Practice Address - Street 1:368 W 13TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3417
Practice Address - Country:US
Practice Address - Phone:305-927-8764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service