Provider Demographics
NPI:1992493977
Name:RODRIGUEZ MARTIN, DAINELYS
Entity type:Individual
Prefix:
First Name:DAINELYS
Middle Name:
Last Name:RODRIGUEZ MARTIN
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 1:14951 SW 82ND LN APT 505
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3119
Mailing Address - Country:US
Mailing Address - Phone:786-668-9501
Mailing Address - Fax:
Practice Address - Street 1:14951 SW 82ND LN APT 505
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3119
Practice Address - Country:US
Practice Address - Phone:786-668-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst