Provider Demographics
NPI:1427470863
Name:RODRIGUEZ-FERNANDEZ, JOHAND (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHAND
Middle Name:
Last Name:RODRIGUEZ-FERNANDEZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3795
Mailing Address - Country:US
Mailing Address - Phone:305-576-6611
Mailing Address - Fax:786-476-2845
Practice Address - Street 1:196 NW 118TH DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8072
Practice Address - Country:US
Practice Address - Phone:787-477-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-18
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10259103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical