Individual provider Active NPI

Kristie Marye Rodriguez Otero, M.D.

  • Pediatric Critical Care Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1104107234
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME132269 Issued in FL
Practice address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone
(305) 661-1515
Fax
(305) 662-3732
NPI assigned
Sep 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 18848 PR
Pediatric Critical Care Medicine Physician 2080P0203X ME132269 FL Primary
Pediatrics Physician 208000000X ME132269 FL

Addresses

Primary practice location

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423

Mailing address

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone (305) 661-1515

Other practice location 1

789 S Federal Hwy
Ft Lauderdale, FL 33316-1218
Phone (954) 315-5784

Other identifiers 1

IdentifierTypeStateIssuer
020915100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME132269FLMDPediatric Critical Care Medicine Physician
18848PRMDPediatric Critical Care Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1104107234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 S Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333161218",
            "country_code": "US",
            "telephone_number": "954-315-5784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ OTERO",
        "first_name": "KRISTIE",
        "middle_name": "MARYE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-02",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "PR",
            "license": "18848",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME132269",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME132269",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020915100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.