Provider Demographics
NPI:1841536315
Name:RODRIGUEZ, JOSE MIGUEL (COTA)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MIGUEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 YUMURI ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3607
Mailing Address - Country:US
Mailing Address - Phone:786-517-6999
Mailing Address - Fax:
Practice Address - Street 1:6901 YUMURI ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3607
Practice Address - Country:US
Practice Address - Phone:786-517-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3609224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant