Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT16947 | FL |
NPI | 1003202177 |
---|---|
Provider Name | Gisel Rodriguez |
First Address | Hialeah, FL 33015-6348 |
Second Address | Pembroke Pines, FL 33026-4387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 15/04/2015 |