Provider Demographics
NPI:1669878112
Name:RODRIGUEZ CAMBAS, AILYN (MH 18571)
Entity type:Individual
Prefix:
First Name:AILYN
Middle Name:
Last Name:RODRIGUEZ CAMBAS
Suffix:
Gender:F
Credentials:MH 18571
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 SW N KENDALL DR.
Mailing Address - Street 2:SUITE 119
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1277
Mailing Address - Country:US
Mailing Address - Phone:786-445-2667
Mailing Address - Fax:
Practice Address - Street 1:4215 SW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4510
Practice Address - Country:US
Practice Address - Phone:305-377-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 104100000X
FLMH18571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker