Provider Demographics
NPI:1710278924
Name:ALEX RODRIGUEZ,PA
Entity Type:Organization
Organization Name:ALEX RODRIGUEZ,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
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 1:8967 SW 52ND PL
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-5125
Mailing Address - Country:US
Mailing Address - Phone:786-586-6992
Mailing Address - Fax:888-803-6946
Practice Address - Street 1:8967 SW 52ND PL
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-5125
Practice Address - Country:US
Practice Address - Phone:786-586-6992
Practice Address - Fax:888-803-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty