Provider Demographics
NPI:1518501295
Name:RODRIGUEZ MARICHAL, LIUVER
Entity type:Individual
Prefix:
First Name:LIUVER
Middle Name:
Last Name:RODRIGUEZ MARICHAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2335 E LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7141
Practice Address - Country:US
Practice Address - Phone:702-840-2538
Practice Address - Fax:877-569-2671
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV857088363LF0000X, 163W00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No163W00000XNursing Service ProvidersRegistered Nurse