Provider Demographics
NPI:1821119165
Name:RODRIGUEZ, REINA ANTONIA (CRT)
Entity Type:Individual
Prefix:
First Name:REINA
Middle Name:ANTONIA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9980 NW 131ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1672
Mailing Address - Country:US
Mailing Address - Phone:305-826-9347
Mailing Address - Fax:
Practice Address - Street 1:9980 NW 131ST ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1672
Practice Address - Country:US
Practice Address - Phone:305-826-9347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT 52332278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care