Provider Demographics
NPI:1467268631
Name:RODRIGUEZ OLIVEROS, ALEJANDRA MERLE
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:MERLE
Last Name:RODRIGUEZ OLIVEROS
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 1:11663 SW 152ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5238
Mailing Address - Country:US
Mailing Address - Phone:305-337-6316
Mailing Address - Fax:
Practice Address - Street 1:11663 SW 152ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5238
Practice Address - Country:US
Practice Address - Phone:305-337-6316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-391068106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician