Provider Demographics
NPI:1316558703
Name:RODRIGUEZ, IVETTE (BPS, MBA, CAP)
Entity type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:BPS, MBA, CAP
Other - Prefix:
Other - First Name:EVIE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:651 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4036
Mailing Address - Country:US
Mailing Address - Phone:321-999-9614
Mailing Address - Fax:
Practice Address - Street 1:651 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4036
Practice Address - Country:US
Practice Address - Phone:321-999-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor