Healthcare Provider Details

I. General information

NPI: 1992556765
Provider Name (Legal Business Name): DALIA GALLARDO RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2592 HOMEWOOD RD APT A
WEST PALM BEACH FL
33406-3134
US

IV. Provider business mailing address

2592 HOMEWOOD RD APT A
WEST PALM BEACH FL
33406-3134
US

V. Phone/Fax

Practice location:
  • Phone: 561-890-3925
  • Fax:
Mailing address:
  • Phone: 561-890-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: