Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1134233885 |
---|---|
Provider Name | Ms. Sonia Ivette Rodriguez |
First Address | Columbia, SC 29212-1636 |
Second Address | Columbia, SC 29209-1638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 09/10/2008 |