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NPI Code Detail

MEDICARE: DR. GABRIEL JOSE RODRIGUEZ TELLADO M.D.

MEDICARE: DR. GABRIEL JOSE RODRIGUEZ TELLADO M.D.
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
1208100000XPhysical Medicine & Rehabilitation PhysicianME160013FL
2390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972034049
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GABRIEL JOSE RODRIGUEZ TELLADO M.D.
Provider Business Mailing Address
First Line : 1776 WOODSTEAD CT STE 208
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-1480
Country : US
Telephone Number : 877-749-7428
Fax Number : 512-628-3314
Provider Business Practice Location Address
First Line : 7000 COBBLE CRK
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-8638
Country : US
Telephone Number : 877-749-7428
Fax Number : 512-628-3314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 11/25/2025

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