Provider Demographics
NPI:1427745868
Name:RODRIGUREZ, YOVANY
Entity type:Individual
Prefix:
First Name:YOVANY
Middle Name:
Last Name:RODRIGUREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 NW 119TH ST UNIT 1117
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7903
Mailing Address - Country:US
Mailing Address - Phone:786-445-3640
Mailing Address - Fax:
Practice Address - Street 1:8851 NW 119TH ST UNIT 1117
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-7903
Practice Address - Country:US
Practice Address - Phone:786-445-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician