Provider Demographics
NPI:1023501400
Name:RODRIGUEZ, MARIA VICTORIA I
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:VICTORIA
Last Name:RODRIGUEZ
Suffix:I
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 1:4742 CREW CIR APT 6
Mailing Address - Street 2:
Mailing Address - City:W MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8449
Mailing Address - Country:US
Mailing Address - Phone:321-208-3946
Mailing Address - Fax:
Practice Address - Street 1:4742 CREW CIR APT 6
Practice Address - Street 2:
Practice Address - City:W MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8449
Practice Address - Country:US
Practice Address - Phone:321-208-3946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst