Provider Demographics
NPI:1205471786
Name:RODRIGUEZ, JAVIER FRANCISCO (RBT)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:FRANCISCO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 SW 97TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2813
Mailing Address - Country:US
Mailing Address - Phone:305-297-1222
Mailing Address - Fax:
Practice Address - Street 1:9920 SW 97TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2813
Practice Address - Country:US
Practice Address - Phone:305-297-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-105425106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty