Provider Demographics
NPI:1962924696
Name:GARCIA RODRIGUEZ, YOSLEIDY
Entity type:Individual
Prefix:
First Name:YOSLEIDY
Middle Name:
Last Name:GARCIA RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14208 SW 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6456
Mailing Address - Country:US
Mailing Address - Phone:786-619-7677
Mailing Address - Fax:
Practice Address - Street 1:14208 SW 160TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6456
Practice Address - Country:US
Practice Address - Phone:786-619-7677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-08595106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018246100Medicaid