Provider Demographics
NPI:1932853983
Name:RODRIGUEZ, YAZMANY (DIETITIAN)
Entity Type:Individual
Prefix:
First Name:YAZMANY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6512 W 2ND CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6716
Mailing Address - Country:US
Mailing Address - Phone:786-237-4463
Mailing Address - Fax:
Practice Address - Street 1:6512 W 2ND CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6716
Practice Address - Country:US
Practice Address - Phone:786-237-4463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9281133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty