Provider Demographics
NPI:1841151115
Name:RODRIGUEZ, KATHYSHELL N (LMT)
Entity type:Individual
Prefix:
First Name:KATHYSHELL
Middle Name:N
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-2674
Mailing Address - Country:US
Mailing Address - Phone:508-736-0100
Mailing Address - Fax:
Practice Address - Street 1:65 SOUTHBRIDGE STRETT
Practice Address - Street 2:SUITE 5
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501
Practice Address - Country:US
Practice Address - Phone:508-736-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18466208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery