Provider Demographics
NPI:1639505738
Name:RODRIGUEZ PACHECO, CRISTINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:RODRIGUEZ PACHECO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1400 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1003
Mailing Address - Country:US
Mailing Address - Phone:305-689-5635
Mailing Address - Fax:305-689-5930
Practice Address - Street 1:1400 NW 12TH AVE
Practice Address - Street 2:DEPARTMENT OF PHYSICAL THERAPY
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1003
Practice Address - Country:US
Practice Address - Phone:305-689-5635
Practice Address - Fax:305-689-5930
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4492225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist