Provider Demographics
NPI:1346127263
Name:RODRIGUEZ, MARISOL (AUD)
Entity type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4754
Mailing Address - Country:US
Mailing Address - Phone:386-756-8225
Mailing Address - Fax:386-767-0742
Practice Address - Street 1:1400 HAND AVE STE M
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8196
Practice Address - Country:US
Practice Address - Phone:386-673-5280
Practice Address - Fax:386-673-8618
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2947231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist