Provider Demographics
NPI:1558955591
Name:RODRIGUEZ MAGARINO, LEDI ROSA
Entity type:Individual
Prefix:
First Name:LEDI
Middle Name:ROSA
Last Name:RODRIGUEZ MAGARINO
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 1:3330 GRANT COVE CIR
Mailing Address - Street 2:APT 108
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991
Mailing Address - Country:US
Mailing Address - Phone:786-365-3788
Mailing Address - Fax:
Practice Address - Street 1:3330 GRANT COVE CIR
Practice Address - Street 2:APT 108
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991
Practice Address - Country:US
Practice Address - Phone:786-365-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-20
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-128537106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician