Healthcare Provider Details

I. General information

NPI: 1558271825
Provider Name (Legal Business Name): AMY RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 FRENCHTOWN RD
NORTH KINGSTOWN RI
02852-1758
US

IV. Provider business mailing address

134 MADISON ST
WARWICK RI
02888-2708
US

V. Phone/Fax

Practice location:
  • Phone: 401-519-5222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA01339
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: