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NPI Code Detail

MEDICARE: GABRIELA NICOLE RODRIGUEZ ORTEGA PA

MEDICARE: GABRIELA NICOLE RODRIGUEZ ORTEGA PA
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1144937277
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELA NICOLE RODRIGUEZ ORTEGA PA
Provider Business Mailing Address
First Line : 1003 ASPRI WAY
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33418-6516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2101 E 48TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80216-2253
Country : US
Telephone Number : 303-458-5302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2022
Last Update Date : 04/13/2023

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Directions to “ GABRIELA NICOLE RODRIGUEZ ORTEGA PA” Practice Location

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