Provider Demographics
NPI:1164238424
Name:RODRIGUEZ, ROSMERY (RMHCI)
Entity type:Individual
Prefix:
First Name:ROSMERY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-3106
Mailing Address - Country:US
Mailing Address - Phone:407-490-6106
Mailing Address - Fax:
Practice Address - Street 1:380 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-3106
Practice Address - Country:US
Practice Address - Phone:407-490-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health