Provider Demographics
NPI:1720683261
Name:RODRIGUEZ ALVAREZ, YANETSY
Entity Type:Individual
Prefix:
First Name:YANETSY
Middle Name:
Last Name:RODRIGUEZ ALVAREZ
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 1:211 NW 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5283
Mailing Address - Country:US
Mailing Address - Phone:786-320-2835
Mailing Address - Fax:
Practice Address - Street 1:211 NW 47TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5283
Practice Address - Country:US
Practice Address - Phone:786-320-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician