Provider Demographics
NPI:1063924421
Name:RODRIGUEZ FELIPE, ROCIO
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:
Last Name:RODRIGUEZ FELIPE
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 1:1045 W 76TH ST APT 172
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3923
Mailing Address - Country:US
Mailing Address - Phone:786-379-3555
Mailing Address - Fax:
Practice Address - Street 1:1045 W 76TH ST APT 172
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3923
Practice Address - Country:US
Practice Address - Phone:786-379-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician