Provider Demographics
NPI:1700615069
Name:RODRIGUEZ LAM, MARIA DEL CARMEN (RBT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:RODRIGUEZ LAM
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14750 SW 26TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5936
Mailing Address - Country:US
Mailing Address - Phone:786-615-4750
Mailing Address - Fax:786-279-0915
Practice Address - Street 1:14750 SW 26TH ST STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5936
Practice Address - Country:US
Practice Address - Phone:786-615-4750
Practice Address - Fax:786-279-0915
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-361722106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician