MEDICARE: DEILY FAIFE 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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1700625324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEILY FAIFE RODRIGUEZ

Provider Business Mailing Address
First Line	:	1218 CARMELLA LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-1103
Country	:	US
Telephone Number	:	813-770-8825
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 CARMELLA LN
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-1103
Country	:	US
Telephone Number	:	813-770-8825
Fax Number	:

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

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	04/15/2026

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Directions to “ DEILY FAIFE RODRIGUEZ ” Practice Location

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