Provider Demographics
NPI:1811725443
Name:RODRIGUEZ TEJEDA, ZARAHYS
Entity type:Individual
Prefix:
First Name:ZARAHYS
Middle Name:
Last Name:RODRIGUEZ TEJEDA
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 1:11504 SW 175TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3988
Mailing Address - Country:US
Mailing Address - Phone:305-985-9548
Mailing Address - Fax:
Practice Address - Street 1:11504 SW 175TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3988
Practice Address - Country:US
Practice Address - Phone:305-985-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24340199106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician