Provider Demographics
NPI:1851091813
Name:RODRIGUEZ ARZUAGA, YOANDRIS
Entity Type:Individual
Prefix:
First Name:YOANDRIS
Middle Name:
Last Name:RODRIGUEZ ARZUAGA
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 1:325 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-3209
Mailing Address - Country:US
Mailing Address - Phone:702-758-1486
Mailing Address - Fax:
Practice Address - Street 1:1601 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5244
Practice Address - Country:US
Practice Address - Phone:702-478-9971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician