| Rodriguez Community Center Corp | |
|
1301 Palm Ave Unit 102 Hialeah FL 33010-3461 | |
| (305) 497-2625 | |
| Not Available |
| Full Name | Rodriguez Community Center Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 Palm Ave Unit 102, Hialeah, Florida |
| Authorized Official Name and Position | Yelian Diaz Alvarez (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3054972625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodriguez Community Center Corp 1301 Palm Ave Unit 102 Hialeah FL 33010-3461 Ph: (305) 497-2625 | Rodriguez Community Center Corp 1301 Palm Ave Unit 102 Hialeah FL 33010-3461 Ph: (305) 497-2625 |
| NPI Number | 1295311728 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 08/28/2025 |
| Certification Date | 08/28/2025 |
| Medicare PECOS PAC ID | 7315395803 |
|---|---|
| Medicare Enrollment ID | O20231121003659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295311728 | NPI | - | NPPES |
| 109975600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Micaela S Benayoun |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073116000 PECOS PAC ID: 0042669913 Enrollment ID: I20231218002750 |
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