Provider Demographics
NPI:1912603986
Name:RODRIGUEZ, FAITH LEEANNE
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:LEEANNE
Last Name:RODRIGUEZ
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 1:30063502 MURPHREE HALL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32612-3001
Mailing Address - Country:US
Mailing Address - Phone:954-646-0979
Mailing Address - Fax:
Practice Address - Street 1:4097 NW 43RD ST
Practice Address - Street 2:STE C
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606
Practice Address - Country:US
Practice Address - Phone:352-372-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician