Provider Demographics
NPI:1770387524
Name:AGUILAR RODRIGUEZ, LIETY
Entity type:Individual
Prefix:
First Name:LIETY
Middle Name:
Last Name:AGUILAR RODRIGUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 MORNAY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3424
Mailing Address - Country:US
Mailing Address - Phone:813-897-4667
Mailing Address - Fax:
Practice Address - Street 1:6010 MORNAY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3424
Practice Address - Country:US
Practice Address - Phone:813-897-4667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-424620106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician