Provider Demographics
NPI:1710485826
Name:RODRIGUEZ, JOSEPH (RPT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17987 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-4403
Mailing Address - Country:US
Mailing Address - Phone:954-450-9603
Mailing Address - Fax:954-450-9603
Practice Address - Street 1:17987 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-4403
Practice Address - Country:US
Practice Address - Phone:786-346-4386
Practice Address - Fax:954-450-9603
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7864225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT7864OtherMEDICAL LICENSE