Individual provider Active NPI

Ambar Marie Morales-Rodriguez

  • Internal Medicine Physician
  • Cape Coral, FL
National Provider Identifier
1053052613
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME169481 Issued in FL
Practice address
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone
(239) 424-1900
Fax
(239) 424-1904
NPI assigned
Apr 6, 2022
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME169481 FL Primary

Addresses

Primary practice location

1138 Country Club Blvd
Cape Coral, FL 33990-3027

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1900

Other practice location 1

12220 SW 91st Ter Apt 615
Miami, FL 33186-4171
Phone (000) 000-0000

Other identifiers 1

IdentifierTypeStateIssuer
124370100MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121002508 FL Practitioner - Internal Medicine 5799210167 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME169481FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Oct 21, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 22, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 21, 2024 Accepting new patients
Lee Health System Inc Internal Medicine CurrentSince Nov 22, 2024 Accepting new patients
Lee Memorial Health System Internal Medicine Current Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

636 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 332-5344

2780 Cleveland Ave
Ste 709
Fort Myers, FL 33901
Phone (239) 343-2551

4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

Organizations & group practices 5

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1053052613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1900",
            "fax_number": "239-424-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 COUNTRY CLUB BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903027",
            "telephone_number": "239-424-1900",
            "fax_number": "239-424-1904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12220 SW 91st Ter Apt 615",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331864171",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORALES-RODRIGUEZ",
        "first_name": "AMBAR",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124370100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.