Provider Demographics
NPI:1689559668
Name:MAUL, RODERICK (RCSWI)
Entity type:Individual
Prefix:
First Name:RODERICK
Middle Name:
Last Name:MAUL
Suffix:
Gender:M
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14227 RIVA RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33573-3302
Mailing Address - Country:US
Mailing Address - Phone:205-718-2793
Mailing Address - Fax:
Practice Address - Street 1:14445 7TH ST
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33523-3126
Practice Address - Country:US
Practice Address - Phone:352-999-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW214641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical