Provider Demographics
NPI:1932638178
Name:RODRIGUEZ CADIZ, TIANA NICOLE
Entity Type:Individual
Prefix:
First Name:TIANA
Middle Name:NICOLE
Last Name:RODRIGUEZ CADIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 CORNERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8130
Mailing Address - Country:US
Mailing Address - Phone:407-921-4546
Mailing Address - Fax:
Practice Address - Street 1:1040 71ST ST STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2978
Practice Address - Country:US
Practice Address - Phone:305-397-8993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-10
Last Update Date:2017-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15909224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant