Individual
TIFFANY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
917 N PENNSYLVANIA AVE, PREMAPLAY LLC, WINTER PARK, FL 32789-2456
(407) 790-5601
(407) 602-7858
Mailing address
1007 LAKEVIEW OAKS DR, CLERMONT, FL 34715-5782
(352) 444-4179
(407) 602-7858
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA13822
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013653800
—
FL
Enumeration date
10/21/2015
Last updated
10/21/2015
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