Individual provider Active NPI

Idayli Perez Rodriguez

  • General Practice Physician
  • Homestead, FL
National Provider Identifier
1174040497
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1086 Issued in FL
Practice address
363 S Homestead Blvd
Homestead, FL 33030-7309
Phone
(305) 775-9839
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 019966 PR
General Practice Physician 208D00000X ACN1086 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X 14321-I PR

Addresses

Primary practice location

363 S Homestead Blvd
Homestead, FL 33030-7309

Mailing address

363 S Homestead Blvd
Homestead, FL 33030-7309
Phone (305) 775-9839

Other identifiers 1

IdentifierTypeStateIssuer
108539300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214001973 FL Practitioner - General Practice 4385989631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9725 NW 117TH Ave
Suite 200
Medley, FL 33178-1260

9853 SW 40TH St
Miami, FL 33165-3993

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019966PRMDGeneral Practice Physician
14321-IPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Cano Health, LLC General Practice CurrentSince Oct 25, 2021 Accepting new patients

Locations

8333 NW 53rd St
Fl 6
Doral, FL 33166

363 S Homestead Blvd
Homestead, FL 33030
Phone (305) 273-6010

9725 NW 117th Ave
Ste 200
Medley, FL 33178
Phone 9545149360 ext. 8515

12600 SW 120th St
Ste 101
Miami, FL 33186
Phone (305) 506-1930

26085 S Dixie Hwy
Naranja, FL 33032
Phone (305) 246-2221

680 N University Dr
Pembroke Pines, FL 33024
Phone (954) 538-6868

Interoperability endpoints

  • Direct secure messaging: idayli.perezrodriguez@chealth.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1174040497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 S HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307309",
            "telephone_number": "305-775-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 S HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330307309",
            "telephone_number": "305-775-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ RODRIGUEZ",
        "first_name": "IDAYLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "019966",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1086",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "14321-I",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108539300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.