Provider Demographics
NPI:1295151041
Name:RODRIGUEZ, CARMEN
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name: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 1:7510 SW 152ND AVE
Mailing Address - Street 2:102C
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3242
Mailing Address - Country:US
Mailing Address - Phone:786-443-9242
Mailing Address - Fax:
Practice Address - Street 1:7510 SW 152ND AVE
Practice Address - Street 2:102C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3242
Practice Address - Country:US
Practice Address - Phone:786-443-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical