Individual
MISS KEISHLA MARIE RODRIGUEZ VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1682 BAY BREEZE DR, SAINT CLOUD, FL 34771-7482
(939) 242-1585
Mailing address
1682 BAY BREEZE DR, SAINT CLOUD, FL 34771-7482
(939) 242-1585
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21493
FL
Other
Enumeration date
04/03/2021
Last updated
04/04/2021
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