Provider Demographics
NPI:1538754429
Name:RODRIGUEZ, MADELAYNE (MS)
Entity type:Individual
Prefix:
First Name:MADELAYNE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 MINOLA DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6038
Mailing Address - Country:US
Mailing Address - Phone:786-417-0157
Mailing Address - Fax:
Practice Address - Street 1:532 MINOLA DR
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-6038
Practice Address - Country:US
Practice Address - Phone:786-417-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health