Provider Demographics
NPI:1295541712
Name:RODRIGUEZ MARTINEZ, ALAN JALLEINS
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:JALLEINS
Last Name:RODRIGUEZ MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10428 KIPLINGER LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7346
Mailing Address - Country:US
Mailing Address - Phone:407-308-9764
Mailing Address - Fax:
Practice Address - Street 1:10428 KIPLINGER LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-7346
Practice Address - Country:US
Practice Address - Phone:407-308-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker