Provider Demographics
NPI:1316742778
Name:DAMAS RODRIGUEZ, YUDIELYS
Entity type:Individual
Prefix:
First Name:YUDIELYS
Middle Name:
Last Name:DAMAS RODRIGUEZ
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 1:3000 SPRINGDALE BLVD APT V216
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6305
Mailing Address - Country:US
Mailing Address - Phone:561-800-7560
Mailing Address - Fax:
Practice Address - Street 1:680 S MILITARY TRL
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-3904
Practice Address - Country:US
Practice Address - Phone:561-800-7560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician