Active NPI
Katherine Rodriguez, D.M.D.
- Periodontics
- Miami, FL
National Provider Identifier
1104086354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 3523
- Practice address
- 1330 Coral Way Ste 100
Miami, FL 33145-2929 - Phone
- (305) 285-5150
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN16597 | FL | |
| Periodontics | 1223P0300X | 3523 | PR | Primary |
Addresses
Primary practice location
1330 Coral Way Ste 100
Miami, FL 33145-2929
Mailing address
G14 Ave Las Palomas
San Juan, PR 00926-6516
Phone (305) 479-5800
Other practice location 1
1738 Calle Amarillo Ste 207A
San Juan, PR 00926-3072
Phone (787) 281-0614
Other practice location 2
15805 Biscayne Blvd Ste 202
Aventura, FL 33160-5377
Phone (305) 652-2255
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150225001317 | FL | Order and Referring Only - Oral Surgery | 6305162991 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3523 | PR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bosque DDS LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Miami, FL
- NPI 1396696761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778716800000",
"number": "1104086354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "G14 AVE LAS PALOMAS",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009266516",
"telephone_number": "305-479-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 CORAL WAY STE 100",
"city": "MIAMI",
"state": "FL",
"postal_code": "331452929",
"telephone_number": "305-285-5150"
}
],
"practiceLocations": [
{
"address_1": "1738 Calle Amarillo Ste 207A",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009263072",
"country_code": "US",
"telephone_number": "787-281-0614",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "15805 Biscayne Blvd Ste 202",
"address_purpose": "LOCATION",
"city": "Aventura",
"state": "FL",
"postal_code": "331605377",
"country_code": "US",
"telephone_number": "305-652-2255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2026-05-14",
"certification_date": "2026-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN16597",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": "PR",
"license": "3523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.