Provider Demographics
NPI:1588436992
Name:SANCHEZ MENDIETA, RODOLFO (RBT)
Entity type:Individual
Prefix:
First Name:RODOLFO
Middle Name:
Last Name:SANCHEZ MENDIETA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 SW 108TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3524
Mailing Address - Country:US
Mailing Address - Phone:305-342-3285
Mailing Address - Fax:
Practice Address - Street 1:3740 SW 108TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3524
Practice Address - Country:US
Practice Address - Phone:305-342-3285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-309045106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician