Provider Demographics
NPI:1891362778
Name:RODRIGUEZ CHI, LISBETH (MSN, PMHNP-BC, FNP-C)
Entity Type:Individual
Prefix:
First Name:LISBETH
Middle Name:
Last Name:RODRIGUEZ CHI
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18000 NW 68TH AVE
Mailing Address - Street 2:APTO 308
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3947
Mailing Address - Country:US
Mailing Address - Phone:786-354-7584
Mailing Address - Fax:
Practice Address - Street 1:625 E 49TH ST FL 2
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1963
Practice Address - Country:US
Practice Address - Phone:305-681-7789
Practice Address - Fax:305-681-7968
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11013570363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily