Healthcare Provider Details

I. General information

NPI: 1760891089
Provider Name (Legal Business Name): PABLO ENRIQUE RODRIGUEZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2014
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 WASHINGTON ST
ATTLEBORO MA
02703-7944
US

IV. Provider business mailing address

1525 WAMPANOAG TRL STE 205
RIVERSIDE RI
02915-1038
US

V. Phone/Fax

Practice location:
  • Phone: 508-761-5945
  • Fax:
Mailing address:
  • Phone: 401-433-4049
  • Fax: 401-433-0612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT02721
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: