Provider Demographics
NPI:1316349608
Name:RODRIGUEZ, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:LITTELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2265 PORTOFINO PL UNIT 2123
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-7739
Mailing Address - Country:US
Mailing Address - Phone:727-560-7388
Mailing Address - Fax:727-213-6246
Practice Address - Street 1:12413 WHITE BLUFF RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-5016
Practice Address - Country:US
Practice Address - Phone:727-741-3405
Practice Address - Fax:727-213-6246
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist