Provider Demographics
NPI:1750688271
Name:RODRIGUEZ, RENE (LMT)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 N KENDALL DR
Mailing Address - Street 2:SUITE 404A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7706
Mailing Address - Country:US
Mailing Address - Phone:305-218-0546
Mailing Address - Fax:
Practice Address - Street 1:7400 N KENDALL DR
Practice Address - Street 2:SUITE 404A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7706
Practice Address - Country:US
Practice Address - Phone:305-218-0546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA37431225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist