MEDICARE: GABRIEL MIGUEL RODRIGUEZ SUAREZ AGNP

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	246ZS0410X	Surgical Technologist	10266	FL
2	363LA2200X	Adult Health Nurse Practitioner	AG03210115	FL
3	363LG0600X	Gerontology Nurse Practitioner	APRN11013151	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366723439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL MIGUEL RODRIGUEZ SUAREZ AGNP

Provider Business Mailing Address
First Line	:	6667 MILLER DR APT 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6446
Country	:	US
Telephone Number	:	786-312-5480
Fax Number	:

Provider Business Practice Location Address
First Line	:	6667 MILLER DR APT 603
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-6446
Country	:	US
Telephone Number	:	786-312-5480
Fax Number	:

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

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	01/04/2023

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