Provider Demographics
NPI:1134816259
Name:RODRIGUEZ, YAQUELIN (RBT-20-127676)
Entity type:Individual
Prefix:MRS
First Name:YAQUELIN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RBT-20-127676
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14475 SW 293RD ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-2946
Mailing Address - Country:US
Mailing Address - Phone:305-394-3959
Mailing Address - Fax:
Practice Address - Street 1:14475 SW 293RD ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-2946
Practice Address - Country:US
Practice Address - Phone:305-394-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20127676106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician