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General NPI Number Information
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NPI Number | 1760127229
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Entity Type | Individual
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Provider Name | KAREN RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 04/29/2022
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Provider Practice Location Address
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Address Line | 4903 NW 55TH BLVD
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City | COCONUT CREEK
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State | FL
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Zip | 33073-3306
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Country | US
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Telephone | 954-464-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 22381 SW 66TH AVE APT 801
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City | BOCA RATON
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State | FL
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Zip | 33428-5307
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Country | US
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Telephone | 561-900-8680
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA16504
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License Number State | FL
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