Provider Demographics
NPI:1518262575
Name:RODRIGUEZ RODRIGUEZ, AIXA M (OTL)
Entity Type:Individual
Prefix:
First Name:AIXA
Middle Name:M
Last Name:RODRIGUEZ RODRIGUEZ
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5068
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00737
Mailing Address - Country:UM
Mailing Address - Phone:787-237-7237
Mailing Address - Fax:787-738-2445
Practice Address - Street 1:CALLE OTILIO LEON NUM 7
Practice Address - Street 2:EL CAMPITO BUENA VISTA
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-0000
Practice Address - Country:US
Practice Address - Phone:787-237-7237
Practice Address - Fax:787-738-2445
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000807225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist