Jefferson Rodrigues de Souza, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9120774 Issued in FL

Practice address

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088

Phone

(904) 245-8910

NPI assigned

Jan 24, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  Medicare reassignment NPD
• Emergency Physicians Inc

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  NPD

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1033921184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 GAN WAY",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322599403",
            "telephone_number": "505-514-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6675 CORPORATE CENTER PKWY STE 115",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168088",
            "telephone_number": "904-245-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUES DE SOUZA",
        "first_name": "JEFFERSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-24",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9120774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Rodicio, DO
• Courtney Rodman, PT
• Chehairazode Alvenetta Rodney, LMHC
• Nicole Rodov
• Corey Rodrigo
• Geraldine Diana Rodrigues-Pratt, ARNP
• Eduardo Rodrigues, MD
• Yailena Rodriguez Amaro
• Gerson Rodriguez Baez, M.D.
• Stella Rodriguez Barrios, M.D.

• Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.