Most Relevant Information
Provider Data
| NPI Number: | 1003657370 |
| Provider Name: | ISIS MARY FUNDORA RODRIGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/03/2024 |
| Last Updated: | 06/03/2024 |
Provider Practice Location
19300 NW 42ND AVE
MIAMI GARDENS
FL
330552225
Practice Location Phone/Fax
| Phone: | 3055898100 |
| Fax: |
Provider Mailing Location
777 NW 72ND AVE STE 1083
MIAMI
FL
331263176
Provider Mailing Phone/Fax
| Phone: | 3053427643 |
| Fax: |