MEDICARE: MISS GINA ALEXIS RODRIGUEZ

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	225700000X	Massage Therapist	7501017170	MI

General Provider Information

NPI Number	:	1639021926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS GINA ALEXIS RODRIGUEZ

Provider Business Mailing Address
First Line	:	3514 KENDALWOOD DR
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-2135
Country	:	US
Telephone Number	:	517-202-1253
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 E SAGINAW ST STE E
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-4716
Country	:	US
Telephone Number	:	517-202-1253
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ MISS GINA ALEXIS RODRIGUEZ ” Practice Location

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