Active NPI
Sarah Rodriguez
- Occupational Therapy Assistant
- Lake Wales, FL
National Provider Identifier
1366033706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 501 Burns Ave
Lake Wales, FL 33853-3335 - Phone
- (863) 679-3338
- Fax
- (863) 455-7049
- NPI assigned
- Jan 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
501 Burns Ave
Lake Wales, FL 33853-3335
Mailing address
2637 Rutledge CT
Winter Haven, FL 33884-5229
Phone (863) 307-7764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Victory Ridge Academy, Inc. | Current | Accepting new patients |
Locations
501 Burns Ave
Lake Wales, FL 33853
Phone (863) 679-3338
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Lake Wales, FL
- NPI 1184044612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680739200000",
"number": "1366033706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2637 RUTLEDGE CT",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338845229",
"telephone_number": "863-307-7764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 BURNS AVE",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338533335",
"telephone_number": "863-679-3338",
"fax_number": "863-455-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-28",
"last_updated": "2023-04-06",
"certification_date": "2023-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Wales, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.