Provider Demographics
NPI:1639307119
Name:GILMORE, PATRICIA RODRIGUEZ (LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:RODRIGUEZ
Last Name:GILMORE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 SW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2300
Mailing Address - Country:US
Mailing Address - Phone:305-857-0050
Mailing Address - Fax:305-854-4948
Practice Address - Street 1:2840 SW 3RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2300
Practice Address - Country:US
Practice Address - Phone:305-857-0050
Practice Address - Fax:305-854-4948
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8670101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health