Healthcare Provider Details

I. General information

NPI: 1306754858
Provider Name (Legal Business Name): GABRIELLE MARIE RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7990 SW 117TH AVE STE 115
MIAMI FL
33183-3845
US

IV. Provider business mailing address

7991 SW 64TH ST
MIAMI FL
33143-2644
US

V. Phone/Fax

Practice location:
  • Phone: 786-646-2555
  • Fax:
Mailing address:
  • Phone: 305-458-1224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number13566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: