Provider Demographics
NPI:1255912325
Name:RODRIGUEZ GIL, SOLANCH N/A
Entity type:Individual
Prefix:
First Name:SOLANCH
Middle Name:N/A
Last Name:RODRIGUEZ GIL
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 1:4198 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1714
Mailing Address - Country:US
Mailing Address - Phone:561-528-0010
Mailing Address - Fax:
Practice Address - Street 1:4198 KENT AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-1714
Practice Address - Country:US
Practice Address - Phone:561-528-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-21-162289106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician