Individual provider Active NPI

Mayli De Las Mercedes Rodriguez

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1174530240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME95869 Issued in FL
Practice address
445 E 25TH St
Hialeah, FL 33013-3810
Phone
(305) 642-5366
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ME95869 FL Primary

Addresses

Primary practice location

445 E 25TH St
Hialeah, FL 33013-3810

Mailing address

445 E 25TH St
Hialeah, FL 33013-3810
Phone (305) 642-5366

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000123 FL Practitioner - Family Practice 3779687553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leon Medical Centers LLCGroup PAC ID 9537066618, 108 clinicians

Practice addresses (Care Compare)

12515 SW 88TH St
Miami, FL 33186-1829
Phone (305) 907-4147

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME95869FLMDInternal Medicine Physician

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174530240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133810",
            "telephone_number": "305-642-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E 25TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133810",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MAYLI",
        "middle_name": "DE LAS MERCEDES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME95869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.