Provider Demographics
NPI:1124732524
Name:RODRIGUEZ, ELIZABETH (IBCLC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10520 NW 74TH ST UNIT 207
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2472
Mailing Address - Country:US
Mailing Address - Phone:832-883-6663
Mailing Address - Fax:
Practice Address - Street 1:10520 NW 74TH ST UNIT 207
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2472
Practice Address - Country:US
Practice Address - Phone:832-883-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-157760174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN