Provider Demographics
NPI:1366723439
Name:RODRIGUEZ SUAREZ, GABRIEL MIGUEL (AGNP)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:MIGUEL
Last Name:RODRIGUEZ SUAREZ
Suffix:
Gender:M
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6667 MILLER DR APT 603
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6446
Mailing Address - Country:US
Mailing Address - Phone:786-312-5480
Mailing Address - Fax:
Practice Address - Street 1:6667 MILLER DR APT 603
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6446
Practice Address - Country:US
Practice Address - Phone:786-312-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10266246ZS0410X
FLAG03210115363LA2200X
FLAPRN11013151363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health