Provider Demographics
NPI:1003125097
Name:RODRIGUEZ-MANRIQUE, LILLIAM V
Entity type:Individual
Prefix:MRS
First Name:LILLIAM
Middle Name:V
Last Name:RODRIGUEZ-MANRIQUE
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 1:14050 SW 84TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4440
Mailing Address - Country:US
Mailing Address - Phone:305-467-6561
Mailing Address - Fax:305-851-0287
Practice Address - Street 1:14050 SW 84TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4440
Practice Address - Country:US
Practice Address - Phone:305-467-6561
Practice Address - Fax:305-851-0287
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-25
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11495235Z00000X
FLSZ5216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty