Juan Chanelo Rodriguez, LMT

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

MA75384 Issued in FL

Practice address

6619 1St Ave S
St Petersburg, FL 33707-1305

Phone

(727) 623-9996

NPI assigned

Mar 3, 2021

Last updated

Mar 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1093300824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9943 14TH ST N APT 204",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337165019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6619 1ST AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071305",
            "telephone_number": "727-623-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANELO RODRIGUEZ",
        "first_name": "JUAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "FL",
            "license": "MA75384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "MA75384",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sebrina Chan
• Neha Chandan, MD
• Himanshu V Chandarana, M.D.
• Cecilia Leticia Chandler, APRN
• Nicole Chandler, MD
• Grace Hui-Yi Chang, PHD
• Henry L Chang, M.D.
• Jenny Chang, DO
• Lilly Chang
• Stella Chang, PA-C

• Recreation Therapist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Recreation Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.