Provider Demographics
NPI:1710368998
Name:RODRIGUEZ, ANN MARIE (ACSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN MARIE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5758 S SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-4818
Mailing Address - Country:US
Mailing Address - Phone:407-241-9046
Mailing Address - Fax:
Practice Address - Street 1:4707 ASHTON DR W
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-4879
Practice Address - Country:US
Practice Address - Phone:407-241-9046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-14
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical