Healthcare Provider Details

I. General information

NPI: 1740777598
Provider Name (Legal Business Name): ASHLEY M RODRIGUEZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 SW 146TH AVE
MIRAMAR FL
33027-3717
US

IV. Provider business mailing address

4050 SW 146TH AVE
MIRAMAR FL
33027-3717
US

V. Phone/Fax

Practice location:
  • Phone: 786-210-9599
  • Fax:
Mailing address:
  • Phone: 786-210-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT19136
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: