Provider Demographics
NPI:1740098284
Name:ACOSTA RODRIGUREZ, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ACOSTA RODRIGUREZ
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 1:18277 NW 61ST PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5604
Mailing Address - Country:US
Mailing Address - Phone:786-631-8672
Mailing Address - Fax:
Practice Address - Street 1:18277 NW 61ST PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5604
Practice Address - Country:US
Practice Address - Phone:786-631-8672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-390116103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst