Provider Demographics
NPI:1467786913
Name:RODRIGUEZ, ANN JANETTE T (PT)
Entity type:Individual
Prefix:
First Name:ANN JANETTE
Middle Name:T
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:ANN JANETTE
Other - Middle Name:REYES
Other - Last Name:TEODORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-0500
Mailing Address - Country:US
Mailing Address - Phone:301-498-8100
Mailing Address - Fax:301-498-0009
Practice Address - Street 1:14955 SHADY GROVE RD STE 230
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8701
Practice Address - Country:US
Practice Address - Phone:301-984-6594
Practice Address - Fax:301-984-7271
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204012225100000X
DCPT870227225100000X
MD21351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21351OtherSTATE DEPARTMENT OF HEALTH