Provider Demographics
NPI:1184397788
Name:CARDO RODRIGUEZ, YANELA
Entity type:Individual
Prefix:
First Name:YANELA
Middle Name:
Last Name:CARDO 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 1:1265 WILDWOOD LAKES BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5817
Mailing Address - Country:US
Mailing Address - Phone:786-372-4542
Mailing Address - Fax:
Practice Address - Street 1:1265 WILDWOOD LAKES BLVD APT 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5817
Practice Address - Country:US
Practice Address - Phone:786-372-4542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician