Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT17454 | FL |
Y | 225X00000X | Occupational Therapist | OTT17454 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OTT17454 | FL |
NPI | 1003271370 |
---|---|
Provider Name | Marisa Rodriguez |
First Address | Gainesville, FL 32606-6895 |
Second Address | Gainesville, FL 32601-4108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2015 |
Last Update Date | 08/03/2016 |