Provider Demographics
NPI:1235317785
Name:ALEX RODRIGUEZ, PA
Entity Type:Organization
Organization Name:ALEX RODRIGUEZ, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:786-586-6992
Mailing Address - Street 1:17150 N BAY RD
Mailing Address - Street 2:2420
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3413
Mailing Address - Country:US
Mailing Address - Phone:786-586-6992
Mailing Address - Fax:786-207-2798
Practice Address - Street 1:17150 N BAY RD
Practice Address - Street 2:2420
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3413
Practice Address - Country:US
Practice Address - Phone:786-586-6992
Practice Address - Fax:786-207-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty