Provider Demographics
NPI:1285961276
Name:NUNEZ RODRIGUEZ, ADOLFO L SR (LMHC, BCBA)
Entity type:Individual
Prefix:MR
First Name:ADOLFO
Middle Name:L
Last Name:NUNEZ RODRIGUEZ
Suffix:SR
Gender:M
Credentials:LMHC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1213
Mailing Address - Country:US
Mailing Address - Phone:786-832-0166
Mailing Address - Fax:786-773-3394
Practice Address - Street 1:2101 W 76TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:786-773-3393
Practice Address - Fax:786-773-3394
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBCBA-1-20-41288103K00000X
FLMH 10015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017457100Medicaid