Individual provider Active NPI

Jai-Lisa Marie Rodriguez, OTR/L

  • Occupational Therapist
  • St Petersburg, FL
National Provider Identifier
1407476104
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT24928 Issued in FL
Practice address
4655 66TH Street North
St. Petersburg, FL 33709
Phone
(727) 546-4700
Fax
(727) 549-8108
NPI assigned
Apr 22, 2020
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT24928 FL
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X OT27767 CA
Pediatric Occupational Therapist 225XP0200X OT27767 CA
Physical Rehabilitation Occupational Therapist 225XP0019X OT24928 FL
Occupational Therapist 225X00000X OT24928 FL Primary
Occupational Therapist 225X00000X OT27767 CA
Neurorehabilitation Occupational Therapist 225XN1300X OT24928 FL

Addresses

Primary practice location

4655 66TH Street North
St. Petersburg, FL 33709

Mailing address

4655 66TH Street North
St. Petersburg, FL 33709
Phone (727) 546-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113000385 FL Practitioner - Occupational Therapist in Private Practice 5597189217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT24928FLMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Rehability at Home, LLC Occupational Therapist CurrentSince Jan 6, 2025 Accepting new patients
Rehabclinics SPT Inc Occupational Therapist PastSince Feb 18, 2024 Accepting new patients
First State Rehab at Home, LLC Occupational Therapist PastSince Dec 1, 2015 Accepting new patients
Sports and Orthopedic Rehabilitation Services Inc PastSince Feb 18, 2024 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1407476104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 66TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33709",
            "telephone_number": "727-546-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 66TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33709",
            "telephone_number": "727-546-4700",
            "fax_number": "727-549-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JAI-LISA",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT24928",
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "CA",
            "license": "OT27767",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT27767",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "FL",
            "license": "OT24928",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT24928",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT27767",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "FL",
            "license": "OT24928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.