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General NPI Number Information
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NPI Number | 1134233885
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Entity Type | Individual
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Provider Name | MS. SONIA IVETTE RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 6439 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-1638
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Country | US
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Telephone | 803-776-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 PACES BROOK AVE APT. 10138
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City | COLUMBIA
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State | SC
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Zip | 29212-1636
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Country | US
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Telephone | 803-351-0122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number |
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License Number State |
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