Provider Demographics
NPI:1699570622
Name:RODRIGUEZ SANCHEZ, LIDY CARIDAD
Entity type:Individual
Prefix:
First Name:LIDY
Middle Name:CARIDAD
Last Name:RODRIGUEZ SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4110
Mailing Address - Country:US
Mailing Address - Phone:727-601-2015
Mailing Address - Fax:
Practice Address - Street 1:7101 62ND ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-4110
Practice Address - Country:US
Practice Address - Phone:727-601-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-410281106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician