MEDICARE: GABRIEL 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	111N00000X	Chiropractor	X012721	NY
2	111N00000X	Chiropractor	CH11988	FL

General Provider Information

NPI Number	:	1427502459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIEL RODRIGUEZ

Provider Business Mailing Address
First Line	:	1060 NW 125TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33168-6436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 NW 125TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33168-6436
Country	:	US
Telephone Number	:	305-912-5822
Fax Number	:

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

Provider Enumeration Date	:	08/08/2016
Last Update Date	:	10/18/2016

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Directions to “ GABRIEL RODRIGUEZ ” Practice Location

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