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General NPI Number Information
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NPI Number | 1740907344
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Entity Type | Organization
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Legal Business Name | CREATING CONNECTIONS THERAPY INC
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 11478 SW 236TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-6213
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Country | US
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Telephone | 305-308-0904
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Fax | 305-508-6627
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Provider Business Mailing Address
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Address Line | 11478 SW 236TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-6213
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Country | US
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Telephone | 305-308-0904
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Fax | 305-508-6627
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Authorized Official
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Title or Position | OWNER
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Name | SHIOMARA RODRIGUEZ
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Credential | MSOTR/L
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Telephone | 305-308-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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