Individual provider Active NPI

Gladys Blanca Granda-Rodriguez, P.YS P.H.D

  • Ph.D. Medical Genetics
  • Miami, FL
National Provider Identifier
1508902313
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
PY -6236 Issued in FL
Practice address
258 NE 27TH St
Miami, FL 33137-4522
Phone
(305) 573-9898
Fax
(305) 573-3711
NPI assigned
Jan 29, 2007
Last updated
Nov 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X PY -6236 FL Primary

Addresses

Primary practice location

258 NE 27TH St
Miami, FL 33137-4522

Mailing address

258 NE 27TH St
Miami, FL 33137-4522
Phone (305) 573-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000154 FL Practitioner - Clinical Psychologist 6608829783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

258 NE 27 St
Miami, FL 33137-4522
Phone (305) 573-9898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY -6236FLMDPh.D. Medical Genetics

Practice roles

OrganizationSpecialtyStatusNew patients
Pedro a. Rodriguez M.D., P.a. Current Accepting new patients
Psychological Consulting, Inc. CurrentSince Oct 16, 2017 Accepting new patients

Locations

258 NE 27th St
Miami, FL 33137
Phone (305) 573-9898

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1508902313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 NE 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331374522",
            "telephone_number": "305-573-9898",
            "fax_number": "305-573-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 NE 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331374522",
            "telephone_number": "305-573-9898",
            "fax_number": "305-573-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDA-RODRIGUEZ",
        "first_name": "GLADYS",
        "middle_name": "BLANCA",
        "name_prefix": "Mrs.",
        "credential": "P.YS  P.H.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "FL",
            "license": "PY -6236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.