Provider Demographics
NPI:1821553579
Name:CARO RODRIGUEZ, CESAR LEANDRO
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:LEANDRO
Last Name:CARO RODRIGUEZ
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 1:2818 NEW YORK ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-4223
Mailing Address - Country:US
Mailing Address - Phone:561-618-5366
Mailing Address - Fax:
Practice Address - Street 1:2818 NEW YORK ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-4223
Practice Address - Country:US
Practice Address - Phone:561-618-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT--19-88688106S00000X
FLC663112903640247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other