Provider Demographics
NPI:1730755448
Name:RODRIGUEZ RODRIGUEZ, ADLIH MARIELIZ
Entity type:Individual
Prefix:
First Name:ADLIH
Middle Name:MARIELIZ
Last Name:RODRIGUEZ RODRIGUEZ
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 1:15300 W COLONIAL DR APT 605
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4282
Mailing Address - Country:US
Mailing Address - Phone:407-417-1662
Mailing Address - Fax:
Practice Address - Street 1:15300 W COLONIAL DR APT 605
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4282
Practice Address - Country:US
Practice Address - Phone:407-417-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician