Provider Demographics
NPI:1154124196
Name:RODRIGUEZ MORALES, STEFANY
Entity type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:RODRIGUEZ MORALES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 PLEASANT BAY LN APT 201
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-0723
Mailing Address - Country:US
Mailing Address - Phone:863-612-8177
Mailing Address - Fax:
Practice Address - Street 1:1626 RIO COVE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-8315
Practice Address - Country:US
Practice Address - Phone:407-431-0520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-362790106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician