Provider Demographics
NPI:1720599707
Name:RODRIGUEZ SANCHEZ, ILIANA
Entity Type:Individual
Prefix:
First Name:ILIANA
Middle Name:
Last Name:RODRIGUEZ SANCHEZ
Suffix:
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 1:14606 SW 115TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7080
Mailing Address - Country:US
Mailing Address - Phone:786-776-9743
Mailing Address - Fax:
Practice Address - Street 1:14606 SW 115TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7080
Practice Address - Country:US
Practice Address - Phone:786-776-9743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-56908106S00000X
0-21-12186106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician