Provider Demographics
NPI:1912604521
Name:RODRIGUEZ, ANTHONY CHRISTOPHER (DPT)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHRISTOPHER
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12500 SW 106TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3706
Mailing Address - Country:US
Mailing Address - Phone:786-444-9240
Mailing Address - Fax:
Practice Address - Street 1:8585 SUNSET DR STE 103B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3753
Practice Address - Country:US
Practice Address - Phone:305-274-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty