Provider Demographics
NPI:1588211833
Name:RODRIGUEZ-GALLO, MARIA F (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:F
Last Name:RODRIGUEZ-GALLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 SW 98TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6365
Mailing Address - Country:US
Mailing Address - Phone:786-487-9105
Mailing Address - Fax:
Practice Address - Street 1:8181 NW 14TH ST STE 300
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1617
Practice Address - Country:US
Practice Address - Phone:305-677-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11003983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11003983Medicaid