Individual
MR. JESRAEL T RODRIGUEZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 LAKE PORT BLVD, LEESBURG, FL 34748-7674
(352) 728-3366
Mailing address
1069 HARMONY LN, CLERMONT, FL 34711-9021
(863) 899-0768
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
Primary
PT10074
FL
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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