Provider Demographics
NPI:1942086780
Name:RODRIGUEZ, SABRINA ALEXANDRA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:ALEXANDRA
Last Name:RODRIGUEZ
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 1:15538 SW 152ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-5464
Mailing Address - Country:US
Mailing Address - Phone:786-209-7931
Mailing Address - Fax:
Practice Address - Street 1:15538 SW 152ND LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-5464
Practice Address - Country:US
Practice Address - Phone:786-209-7931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-295167106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician