Active NPI
Luz M Fernandez Rodriguez
- Developmental Therapist
- Braintree, MA
National Provider Identifier
1821345869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- S32550693
- Practice address
- 327 Lisle St
Braintree, MA 02184-5028 - Phone
- (617) 412-6896
- NPI assigned
- Aug 9, 2012
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | S32550693 | MA | Primary |
Addresses
Primary practice location
327 Lisle St
Braintree, MA 02184-5028
Mailing address
327 Lisle St
Braintree, MA 02184-5028
Phone (617) 412-6896
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S32550693 | MA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1821345869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 LISLE ST",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021845028",
"telephone_number": "617-412-6896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 LISLE ST",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021845028",
"telephone_number": "617-412-6896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ RODRIGUEZ",
"first_name": "LUZ",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-09",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "MA",
"license": "S32550693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.