Provider Demographics
NPI:1962819821
Name:RODRIGUEZ-VIADA, MARIA GUADALUPE (LCSW-MPH)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GUADALUPE
Last Name:RODRIGUEZ-VIADA
Suffix:
Gender:F
Credentials:LCSW-MPH
Other - Prefix:MRS
Other - First Name:GUADALUPE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8400 NW 33RD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1937
Mailing Address - Country:US
Mailing Address - Phone:305-496-4305
Mailing Address - Fax:
Practice Address - Street 1:8400 NW 33RD ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1937
Practice Address - Country:US
Practice Address - Phone:305-496-4305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 92491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical