Individual provider Active NPI

Raziela Rodriguez

  • Mental Health Counselor
  • Davie, FL
National Provider Identifier
1114512506
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW17307 Issued in FL
Practice address
5400 S University Dr Ste 118
Davie, FL 33328-5309
Phone
(954) 378-5381
NPI assigned
Mar 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW17307 FL Primary
Clinical Social Worker 1041C0700X 17307 FL

Addresses

Primary practice location

5400 S University Dr Ste 118
Davie, FL 33328-5309

Mailing address

1111 E Sunrise Blvd Unit 50
Fort Lauderdale, FL 33304-2847
Phone (786) 301-6287

Other practice location 1

725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000334 FL Practitioner - Clinical Social Worker 3870970635 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW17307FLMDMental Health Counselor
17307FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Health Partners, Inc. CurrentSince Apr 7, 2022 Accepting new patients
MCR Health, Inc. CurrentSince Jul 12, 2022 Accepting new patients
Aldad Medical PC CurrentSince Mar 1, 2023 Accepting new patients
Aldad Medical PC Clinical CurrentSince Mar 1, 2023 Accepting new patients
MCR Health, Inc. CurrentSince Jul 12, 2022 Accepting new patients
Balanced Wellbeing LLC Clinical CurrentSince May 1, 2022 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

801 Brickell Ave
Fl 8
Miami, FL 33131
Phone (305) 871-4420

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

1800 Mercy Dr
Orlando, FL 32808
Phone (407) 295-5151

450 S Orange Ave
Fl 3
Orlando, FL 32801
Phone (407) 212-7113

5151 Adanson St
Ste 201
Orlando, FL 32804
Phone (407) 494-1509

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

1600 E 8th Ave
Ste A200
Tampa, FL 33605

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Organizations & group practices 6

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": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1114512506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E SUNRISE BLVD UNIT 50",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042847",
            "telephone_number": "786-301-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 118",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285309",
            "telephone_number": "954-378-5381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAZIELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-08",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW17307",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.