Provider Demographics
NPI:1902185226
Name:RODRIGUEZ, YUNEIDYS (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:YUNEIDYS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SE SANTA BARBARA PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1072
Mailing Address - Country:US
Mailing Address - Phone:239-440-0467
Mailing Address - Fax:
Practice Address - Street 1:8750 GLADIOLUS DRIVE
Practice Address - Street 2:SUITE 5
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908
Practice Address - Country:US
Practice Address - Phone:239-689-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 63245225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist