MEDICARE: PATRICIA RODRIGUEZ GILMORE L.M.H.C.

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	101YM0800X	Mental Health Counselor	MH8670	FL

General Provider Information

NPI Number	:	1639307119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA RODRIGUEZ GILMORE L.M.H.C.

Provider Business Mailing Address
First Line	:	2840 SW 3RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33129-2300
Country	:	US
Telephone Number	:	305-857-0050
Fax Number	:	305-854-4948

Provider Business Practice Location Address
First Line	:	2840 SW 3RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33129-2300
Country	:	US
Telephone Number	:	305-857-0050
Fax Number	:	305-854-4948

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

Provider Enumeration Date	:	06/23/2009
Last Update Date	:	03/02/2012

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