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NPI Code Detail

MEDICARE: CHARITO RODRIGUEZ OT

MEDICARE: CHARITO RODRIGUEZ OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational TherapistOT006289GA

General Provider Information

NPI Number : 1346964913
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARITO RODRIGUEZ OT
Provider Business Mailing Address
First Line : 4212 CORAL PARK DR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-3016
Country : US
Telephone Number : 912-342-8016
Fax Number : 912-342-8016
Provider Business Practice Location Address
First Line : 1110 S PIERCE ST STE A
Second Line :
City : ALMA
State : GA
Zip : 31510-3718
Country : US
Telephone Number : 912-342-8875
Fax Number : 912-342-8016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2022
Last Update Date : 09/28/2022

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Directions to “ CHARITO RODRIGUEZ OT” Practice Location

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