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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
1390200000XStudent in an Organized Health Care Education/Training Program
2208100000XPhysical Medicine & Rehabilitation PhysicianME160013FL

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 : 6435 DUNLIETH PL
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-7887
Country : US
Telephone Number : 404-234-9007
Fax Number : 850-474-9060
Provider Business Practice Location Address
First Line : 1101 OFFICE WOODS DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-5937
Country : US
Telephone Number : 404-234-9007
Fax Number : 850-474-9060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 03/18/2026

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