Provider Demographics
NPI:1114799087
Name:RODRIGUEZ, CYNTHIA CATHERINE (LMT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:CATHERINE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:CATHERINE
Other - Last Name:ALFONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:9370 SW 8TH ST APT 111
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-6845
Mailing Address - Country:US
Mailing Address - Phone:561-275-4420
Mailing Address - Fax:
Practice Address - Street 1:9370 SW 8TH ST APT 111
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-6845
Practice Address - Country:US
Practice Address - Phone:561-275-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA101567225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist