Provider Demographics
NPI:1306546247
Name:FINALE RODRIGUEZ, LIZA MARIEN
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:MARIEN
Last Name:FINALE 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 1:2410 SW 100TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7549
Mailing Address - Country:US
Mailing Address - Phone:786-423-8059
Mailing Address - Fax:
Practice Address - Street 1:2410 SW 100TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-7549
Practice Address - Country:US
Practice Address - Phone:786-423-8059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician