Healthcare Provider Details

I. General information

NPI: 1457041295
Provider Name (Legal Business Name): EVELYN RODRIGUEZ ARZOLA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5165 ADANSON ST
ORLANDO FL
32804-1331
US

IV. Provider business mailing address

8924 GIBBS HILL ST
ORLANDO FL
32827-5192
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-0212
  • Fax:
Mailing address:
  • Phone: 787-587-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24014
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: