Provider Demographics
NPI:1962250563
Name:JALED RODRIGUEZ, KAREN (OTR/L)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:JALED RODRIGUEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14250 SW 62ND ST APT 222
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1929
Mailing Address - Country:US
Mailing Address - Phone:305-316-8590
Mailing Address - Fax:
Practice Address - Street 1:14250 SW 62ND ST APT 222
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1929
Practice Address - Country:US
Practice Address - Phone:305-316-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22938225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist