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NPI 1720719909

NPI 1720719909 : GABRIELA RODRIGUEZ : POMPANO BEACH, FL

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General NPI Number Information
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    NPI Number           |    1720719909
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    Entity Type          |    Individual 
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    Provider Name        |    GABRIELA RODRIGUEZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/20/2022
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    Last Update Date     |    06/20/2022
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Provider Practice Location Address
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    Address Line         |    3170 N FEDERAL HWY STE 209 
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    City                 |    POMPANO BEACH
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    State                |    FL
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    Zip                  |    33064-6722
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    Country              |    US
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    Telephone            |    267-574-2457
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3170 N FEDERAL HWY STE 209 
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    City                 |    POMPANO BEACH
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    State                |    FL
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    Zip                  |    33064-6722
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    Country              |    US
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    Telephone            |    267-574-2457
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    Fax                  |    
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    
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    License Number State |    
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