Active NPI
Nicole E Rodriguez, M.D.
- Pediatrics Physician
- Orlando, FL
National Provider Identifier
1144637539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME138250
- Practice address
- 5900 S John Young Pkwy
Orlando, FL 32839-3716 - Phone
- (407) 434-8171
- NPI assigned
- Jul 17, 2014
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 31153 | PR | |
| Pediatrics Physician | 208000000X | ME138250 | FL | Primary |
Addresses
Primary practice location
5900 S John Young Pkwy
Orlando, FL 32839-3716
Mailing address
5900 S John Young Pkwy
Orlando, FL 32839-3716
Phone (407) 434-8171
Other practice location 1
917 Ave Tito Castro
Ponce, PR 00716-4717
Phone (787) 840-2080 ext. 1649
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME138250 | FL | MD | Pediatrics Physician |
| 31153 | PR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Night Lite Pediatric Center, LLC | Pediatrics | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Apopka, FL
- NPI 1407974579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1144637539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 S JOHN YOUNG PKWY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328393716",
"telephone_number": "407-434-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 S JOHN YOUNG PKWY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328393716",
"telephone_number": "407-434-8171"
}
],
"practiceLocations": [
{
"address_1": "917 Ave Tito Castro",
"address_purpose": "LOCATION",
"city": "Ponce",
"state": "PR",
"postal_code": "007164717",
"country_code": "US",
"telephone_number": "787-840-2080 x1649",
"fax_number": "787-844-1372",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "NICOLE",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2021-05-20",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PR",
"license": "31153",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME138250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.