Provider Demographics
NPI:1144368705
Name:RODRIGUEZ, HUGO ROBERTO (MSPT)
Entity type:Individual
Prefix:MR
First Name:HUGO
Middle Name:ROBERTO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9097 E DESERT COVE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6279
Mailing Address - Country:US
Mailing Address - Phone:602-285-0949
Mailing Address - Fax:602-285-0052
Practice Address - Street 1:1847 W HEATHERBRAE DR
Practice Address - Street 2:SUITE B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-4764
Practice Address - Country:US
Practice Address - Phone:602-285-0949
Practice Address - Fax:602-285-0052
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist