Provider Demographics
NPI:1396295135
Name:RODRIGUEZ, LEIDYBETH (PSYD)
Entity type:Individual
Prefix:
First Name:LEIDYBETH
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 NW 9TH AVE
Mailing Address - Street 2:SUITE 3308
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1409
Mailing Address - Country:US
Mailing Address - Phone:305-355-9028
Mailing Address - Fax:
Practice Address - Street 1:1695 NW 9TH AVE
Practice Address - Street 2:SUITE 3308
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1409
Practice Address - Country:US
Practice Address - Phone:305-355-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9674103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist