MEDICARE: MARISOL GARCIA RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11039763	FL

General Provider Information

NPI Number	:	1255223897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISOL GARCIA RODRIGUEZ

Provider Business Mailing Address
First Line	:	16520 SW 85TH LN
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33193-5794
Country	:	US
Telephone Number	:	786-608-3364
Fax Number	:

Provider Business Practice Location Address
First Line	:	13595 SW 134TH AVE STE 209
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4580
Country	:	US
Telephone Number	:	305-259-6771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/17/2025

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