Provider Demographics
NPI:1730536442
Name:RODRIGUEZ, MILEIDY
Entity type:Individual
Prefix:
First Name:MILEIDY
Middle Name:
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 1:2050 W CROWN POINTE BLVD APT 211
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-3646
Mailing Address - Country:US
Mailing Address - Phone:786-800-1982
Mailing Address - Fax:
Practice Address - Street 1:2050 W CROWN POINTE BLVD APT 211
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-3646
Practice Address - Country:US
Practice Address - Phone:786-800-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-19-37083103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst