Individual provider Active NPI

Marie Rodriguez, MD

  • Internal Medicine Physician
  • Kissimmee, FL
National Provider Identifier
1144249954
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME77642 Issued in FL
Practice address
931 W Oak St
Ste 103
Kissimmee, FL 34741-4973
Phone
(407) 931-0444
Fax
(407) 962-4446
NPI assigned
Jul 19, 2006
Last updated
Jul 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME77642 FL Primary

Addresses

Primary practice location

931 W Oak St
Ste 103
Kissimmee, FL 34741-4973

Mailing address

9753 S Orange Blossom TRL
Ste 102
Orlando, FL 32837-7841
Phone (407) 412-5985

Other identifiers 2

IdentifierTypeStateIssuer
P00669495OtherFLRR MEDICARE
271508200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, ID, MT, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040901001173 FL Practitioner - Internal Medicine 1456326354
I20110810000502 ID Practitioner - Internal Medicine 1456326354 Reassigns benefits to 1 organization
I20230202000421 MT Practitioner - Internal Medicine 1456326354 Reassigns benefits to 1 organization
I20230908002210 GA Practitioner - Internal Medicine 1456326354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME77642FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Imaging of Georgia LLC CurrentSince Jun 28, 2025 Accepting new patients
Scltdi JV, LLC CurrentSince May 1, 2025 Accepting new patients
American Health Imaging of Georgia, LLC CurrentSince Feb 1, 2026 Accepting new patients
American Health Imaging of Georgia, LLC CurrentSince Jan 1, 2026 Accepting new patients
Scltdi JV, LLC CurrentSince Dec 1, 2024 Accepting new patients
Scltdi JV, LLC CurrentSince Dec 1, 2024 Accepting new patients
Scltdi JV, LLC CurrentSince Nov 12, 2024 Accepting new patients
Scltdi JV, LLC CurrentSince Sep 30, 2024 Accepting new patients
Signify Health, LLC CurrentSince Jan 12, 2023 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince Feb 1, 2026 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince Jan 29, 2026 Accepting new patients
Florida Medical Associates LLC PastSince Apr 3, 2023 Accepting new patients
Primary Medical Care R Ayala MD PA PastSince Jul 20, 2009 Accepting new patients

Locations

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1144249954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9753 S ORANGE BLOSSOM TRL",
            "address_2": "STE 102",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377841",
            "telephone_number": "407-412-5985",
            "fax_number": "407-412-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 W OAK ST",
            "address_2": "STE 103",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414973",
            "telephone_number": "407-931-0444",
            "fax_number": "407-962-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME77642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00669495",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271508200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.