Individual provider Active NPI

Raul Armando Rodriguez, CHIROPRACTOR

  • Chiropractor
  • Doral, FL
National Provider Identifier
1073535654
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7718 Issued in FL
Practice address
3900 NW 79TH Ave
Suite 100
Doral, FL 33166-6556
Phone
(305) 499-9968
Fax
(305) 639-4766
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7718 FL Primary

Addresses

Primary practice location

3900 NW 79TH Ave
Suite 100
Doral, FL 33166-6556

Mailing address

10647 SW 102ND St
Miami, FL 33176-2733
Phone (305) 279-0780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100709000309 FL Practitioner - Chiropractic 5294867206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH7718FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Jul 10, 2012 Accepting new patients
Raul a. Rodriguez D.C. P.a Chiropractor PastSince Jan 16, 2010 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

445 E 25th St
Hialeah, FL 33013
Phone (305) 646-3756

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073535654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10647 SW 102ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762733",
            "telephone_number": "305-279-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 NW 79TH AVE",
            "address_2": "SUITE 100",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666556",
            "telephone_number": "305-499-9968",
            "fax_number": "305-639-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAUL",
        "middle_name": "ARMANDO",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.