MEDICARE: GRACIELA GARCIA RODRIGUEZ FNP-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	363L00000X	Nurse Practitioner	1079932	TX

General Provider Information

NPI Number	:	1790666451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACIELA GARCIA RODRIGUEZ FNP-C

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	361-452-9320
Fax Number	:	361-452-9321

Provider Business Practice Location Address
First Line	:	6182 DUNBARTON OAK ST STE B
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78414-4276
Country	:	US
Telephone Number	:	361-452-9320
Fax Number	:	361-452-9321

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

Provider Enumeration Date	:	09/09/2025
Last Update Date	:	04/07/2026

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