Provider Demographics
NPI:1730846841
Name:RODRIGUEZ SUAREZ, DIANA DE LA CARIDAD
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:DE LA CARIDAD
Last Name:RODRIGUEZ SUAREZ
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 1:6250 HAZELTINE NATIONAL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5102
Mailing Address - Country:US
Mailing Address - Phone:407-237-9955
Mailing Address - Fax:833-792-1182
Practice Address - Street 1:6250 HAZELTINE NATIONAL DR STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5102
Practice Address - Country:US
Practice Address - Phone:407-237-9955
Practice Address - Fax:833-792-1182
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician