Healthcare Provider Details

I. General information

NPI: 1053824680
Provider Name (Legal Business Name): CHRISTINE RODRIGUEZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 US HIGHWAY 1 S
SAINT AUGUSTINE FL
32086-6191
US

IV. Provider business mailing address

128 AIKEN ST
SAINT AUGUSTINE FL
32084-4030
US

V. Phone/Fax

Practice location:
  • Phone: 904-829-3411
  • Fax:
Mailing address:
  • Phone: 305-301-7491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA50849
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT32151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: