MEDICARE: GABRIELLA RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	9121500	FL

General Provider Information

NPI Number	:	1063355667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLA RODRIGUEZ

Provider Business Mailing Address
First Line	:	1021 35TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2919 W SWANN AVE STE 106
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4049
Country	:	US
Telephone Number	:	813-930-2829
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ GABRIELLA RODRIGUEZ ” Practice Location

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