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NPI Code Detail

MEDICARE: JUAN CARLOS RODRIGUEZ PTA

MEDICARE: JUAN CARLOS RODRIGUEZ PTA
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
1225200000XPhysical Therapy Assistant10629AL

General Provider Information

NPI Number : 1528777372
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN CARLOS RODRIGUEZ PTA
Provider Business Mailing Address
First Line : 3500 CLAIRMONT AVE S APT 223
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35222-3529
Country : US
Telephone Number : 305-310-4859
Fax Number :
Provider Business Practice Location Address
First Line : 400 UNIVERSITY PARK DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-6784
Country : US
Telephone Number : 205-870-0786
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2022
Last Update Date : 11/21/2022

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