Provider Demographics
NPI:1821004839
Name:RODRIGUEZ, NANCY (PT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13403 BOYETTE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-8742
Mailing Address - Country:US
Mailing Address - Phone:813-530-0520
Mailing Address - Fax:813-530-0521
Practice Address - Street 1:13403 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-8742
Practice Address - Country:US
Practice Address - Phone:813-530-0520
Practice Address - Fax:813-530-0521
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist