Provider Demographics
NPI:1265231773
Name:RODRIGUEZ DIAZ, MAYTE
Entity type:Individual
Prefix:
First Name:MAYTE
Middle Name:
Last Name:RODRIGUEZ DIAZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10021 SW 42ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5046
Mailing Address - Country:US
Mailing Address - Phone:786-355-0951
Mailing Address - Fax:
Practice Address - Street 1:10691 N KENDALL DR STE 314
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1551
Practice Address - Country:US
Practice Address - Phone:786-534-7172
Practice Address - Fax:305-441-9069
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician