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NPI 1225263023

NPI 1225263023 : GERARDO UMABEL RODRIGUEZ L.M.T. : WELLINGTON, FL

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General NPI Number Information
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    NPI Number           |    1225263023
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    Entity Type          |    Individual 
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    Provider Name        |    GERARDO UMABEL RODRIGUEZ L.M.T.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/21/2009
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    Last Update Date     |    05/21/2009
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Provider Practice Location Address
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    Address Line         |    12290 DARTMOOR DR 
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    City                 |    WELLINGTON
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    State                |    FL
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    Zip                  |    33414-5530
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    Country              |    US
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    Telephone            |    561-302-9897
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    Fax                  |    561-795-4443
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Provider Business Mailing Address
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    Address Line         |    12290 DARTMOOR DR 
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    City                 |    WELLINGTON
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    State                |    FL
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    Zip                  |    33414-5530
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    Country              |    US
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    Telephone            |    561-302-9897
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    Fax                  |    561-795-4443
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    24978
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    License Number State |    FL
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