Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA81292 | FL |
NPI | 1003344763 |
---|---|
Provider Name | Ruvi Rodriguez |
First Address | Wauchula, FL 33873-2737 |
Second Address | Sebring, FL 33870-8515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2017 |
Last Update Date | 25/05/2017 |