Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT18804 | FL |
NPI | 1003242199 |
---|---|
Provider Name | Shiomara Rodriguez |
First Address | Homestead, FL 33032-6213 |
Second Address | Homestead, FL 33032-6213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2013 |
Last Update Date | 19/10/2017 |