Provider Demographics
NPI:1760660955
Name:RIALUBIN, RODOLFO PAGADOR JR (RPT)
Entity Type:Individual
Prefix:MR
First Name:RODOLFO
Middle Name:PAGADOR
Last Name:RIALUBIN
Suffix:JR
Gender:M
Credentials:RPT
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Mailing Address - Street 1:3290 N RIDGE RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3655
Mailing Address - Country:US
Mailing Address - Phone:410-750-9006
Mailing Address - Fax:410-750-0787
Practice Address - Street 1:3201 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3440
Practice Address - Country:US
Practice Address - Phone:954-332-4445
Practice Address - Fax:954-332-4340
Is Sole Proprietor?:No
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
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Provider Licenses
StateLicense IDTaxonomies
OR05591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist