Healthcare Provider Details

I. General information

NPI: 1740887678
Provider Name (Legal Business Name): GABRIEL PARDO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MINORCA AVE STE 101
CORAL GABLES FL
33134-4330
US

IV. Provider business mailing address

10470 SW 96TH ST
MIAMI FL
33176-2624
US

V. Phone/Fax

Practice location:
  • Phone: 305-778-0453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number36295
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: