Individual
MR. RANDOLPH RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2434 BENJAMIN DR, KISSIMMEE, FL 34744-2722
(407) 558-5656
Mailing address
3201 BUDINGER AVE, SAINT CLOUD, FL 34769-7203
(407) 910-2941
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13834
FL
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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