Individual provider Active NPI

Alejandro Enrique Rodulfo Rodriguez, MD

  • Psychiatry Physician
  • Hollywood, FL
National Provider Identifier
1093374183
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME162919 Issued in FL
Practice address
3440 Hollywood Blvd Ste 360
Hollywood, FL 33021-6934
Phone
(954) 276-9240
Fax
(954) 276-0103
NPI assigned
Jun 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME162919 FL Primary

Addresses

Primary practice location

3440 Hollywood Blvd Ste 360
Hollywood, FL 33021-6934

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-6818
Phone (954) 276-5603

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
I20231106003169 FL Practitioner - Psychiatry 3274867981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

3440 Hollywood Blvd
Suite 360
Hollywood, FL 33021-6934
Phone (954) 276-9240

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-4613

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME162919FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District Psychiatry CurrentSince Jul 29, 2023 Accepting new patients
South Broward Hospital District CurrentSince Jul 29, 2023 Accepting new patients

Locations

3440 Hollywood Blvd
Ste 360
Hollywood, FL 33021
Phone (954) 276-9200

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1093374183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256818",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 HOLLYWOOD BLVD STE 360",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216934",
            "telephone_number": "954-276-9240",
            "fax_number": "954-276-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODULFO RODRIGUEZ",
        "first_name": "ALEJANDRO",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME162919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.