MEDICARE: MRS. MARGARITE RODRIGUEZ PODDER PT

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
1	225100000X	Physical Therapist	12168	FL

General Provider Information

NPI Number	:	1417167529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARITE RODRIGUEZ PODDER PT

Provider Business Mailing Address
First Line	:	16784 VALENCIA BLVD
Second Line	:
City	:	LOXAHATCHEE
State	:	FL
Zip	:	33470-2715
Country	:	US
Telephone Number	:	561-753-5496
Fax Number	:	561-753-5496

Provider Business Practice Location Address
First Line	:	11000 PROSPERITY FARMS RD STE 203
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3462
Country	:	US
Telephone Number	:	561-432-0111
Fax Number	:	561-432-1075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/24/2020

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