Provider Demographics
NPI:1417358318
Name:ROSARIO-RODRIGUEZ, NEYSHA (MSC, OTR/L)
Entity Type:Individual
Prefix:
First Name:NEYSHA
Middle Name:
Last Name:ROSARIO-RODRIGUEZ
Suffix:
Gender:F
Credentials:MSC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 SW 116TH AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7568
Mailing Address - Country:US
Mailing Address - Phone:787-406-5421
Mailing Address - Fax:
Practice Address - Street 1:2751 SW 116TH AVE APT 102
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7568
Practice Address - Country:US
Practice Address - Phone:787-406-5421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1239225XP0019X, 225XP0200X
FL18840225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics