Provider Demographics
NPI:1831561380
Name:RODRIGUEZ, JOANNA P (BS)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:P
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13741 SW 84TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4034
Mailing Address - Country:US
Mailing Address - Phone:786-668-7066
Mailing Address - Fax:
Practice Address - Street 1:13741 SW 84TH ST APT A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4034
Practice Address - Country:US
Practice Address - Phone:786-668-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician