Provider Demographics
NPI:1235484536
Name:RODRIGUEZ, ARACELIS (DPT)
Entity Type:Individual
Prefix:DR
First Name:ARACELIS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 RUNNING SPRINGS LOOP
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9638
Mailing Address - Country:US
Mailing Address - Phone:407-542-0947
Mailing Address - Fax:407-542-3993
Practice Address - Street 1:120 ALEXANDRIA BLVD
Practice Address - Street 2:17
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8299
Practice Address - Country:US
Practice Address - Phone:407-545-0947
Practice Address - Fax:407-542-3993
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27525225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist