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NPI Code Detail

MEDICARE: MR. ERNEST PAUL RODRIGUEZ M.P.T.

MEDICARE: MR. ERNEST PAUL RODRIGUEZ M.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305202654VA

General Provider Information

NPI Number : 1487608535
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERNEST PAUL RODRIGUEZ M.P.T.
Provider Business Mailing Address
First Line : 5301 PROVIDENCE RD
Second Line : SUITE 80
City : VIRGINIA BEACH
State : VA
Zip : 23464-4128
Country : US
Telephone Number : 757-467-1900
Fax Number : 757-467-7900
Provider Business Practice Location Address
First Line : 5301 PROVIDENCE RD
Second Line : SUITE 80
City : VIRGINIA BEACH
State : VA
Zip : 23464-4128
Country : US
Telephone Number : 757-467-1900
Fax Number : 757-467-7900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2006
Last Update Date : 07/08/2007

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