Healthcare Provider Details

I. General information

NPI: 1356261085
Provider Name (Legal Business Name): GABRIEL RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB VILLA FORESTAL D-14 AVE EL YUNKE
MANATI PR
00674-0000
US

IV. Provider business mailing address

G4 CALLE 24
MOROVIS PR
00687-2030
US

V. Phone/Fax

Practice location:
  • Phone: 254-345-1898
  • Fax:
Mailing address:
  • Phone: 254-345-1898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberTCAMB-126341
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: