Provider Demographics
NPI:1174110902
Name:RODRIGUEZ, MICHEL SALVADOR (RBT)
Entity type:Individual
Prefix:MR
First Name:MICHEL
Middle Name:SALVADOR
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1170
Mailing Address - Country:US
Mailing Address - Phone:305-988-1494
Mailing Address - Fax:
Practice Address - Street 1:5250 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1170
Practice Address - Country:US
Practice Address - Phone:305-988-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-143782106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician