Individual provider Active NPI

Marialy Rodriguez Hernandez, ARNP

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1043804008
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11011690 Issued in FL
Practice address
1425 Viscaya Pkwy Ste 205
Cape Coral, FL 33990-3294
Phone
(239) 471-7407
Fax
(239) 673-1378
NPI assigned
Feb 21, 2021
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11011690 FL Primary

Addresses

Primary practice location

1425 Viscaya Pkwy Ste 205
Cape Coral, FL 33990-3294

Mailing address

2809 SW 8TH PL
Cape Coral, FL 33914-4204
Phone (786) 564-6050

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316001213 FL Practitioner - Nurse Practitioner 3577979665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4304 Del Prado Blvd S
Cape Coral, FL 33904-7169
Phone (239) 471-7407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11011690FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NH Medical Institute LLC CurrentSince Mar 1, 2024 Accepting new patients
Excellence Medical Centers,LLC PastSince Sep 21, 2010 Accepting new patients

Locations

1425 Viscaya Pkwy
Ste 205
Cape Coral, FL 33990
Phone (239) 471-7407

4304 Del Prado Blvd S
Cape Coral, FL 33904
Phone (239) 471-7407

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": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1043804008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 SW 8TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144204",
            "telephone_number": "786-564-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 VISCAYA PKWY STE 205",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903294",
            "telephone_number": "239-471-7407",
            "fax_number": "239-673-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ HERNANDEZ",
        "first_name": "MARIALY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.