Individual provider Active NPI

Katherine Rodriguez, M.D.

  • General Practice Physician
  • Sarasota, FL
National Provider Identifier
1194165951
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME121720 Issued in FL
Practice address
1956 Cattlemen Rd
Sarasota, FL 34232-6237
Phone
(727) 946-1568
Fax
(727) 245-0224
NPI assigned
Jun 26, 2013
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME121720 FL Primary

Addresses

Primary practice location

1956 Cattlemen Rd
Sarasota, FL 34232-6237

Mailing address

1956 Cattlemen Rd
Sarasota, FL 34232-6237
Phone (727) 946-1568

Other identifiers 2

IdentifierTypeStateIssuer
1194165951OtherFLDEA REGISTRATION
1194195158OtherFLMEDICAL LICENSE

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
I20230616000644 FL Practitioner - Preventive Medicine 9032577671

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME121720FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince May 16, 2024 Accepting new patients
Theoria Medical Past Accepting new patients
Complexcare Medical Group Midwest M PLLC Past Accepting new patients

Locations

207 Hospital Dr NE
Fort Walton Beach, FL 32548
Phone (850) 833-9165

701 Lake Port Blvd
Leesburg, FL 34748
Phone (352) 728-3366

1053 John Sims Pkwy E
Niceville, FL 32578
Phone (850) 768-0213

900 Beckett Way
Tarpon Springs, FL 34689
Phone (727) 934-0876

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1194165951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 CATTLEMEN RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326237",
            "telephone_number": "727-946-1568",
            "fax_number": "727-245-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 CATTLEMEN RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342326237",
            "telephone_number": "727-946-1568",
            "fax_number": "727-245-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME121720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEA REGISTRATION",
            "identifier": "1194165951",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "1194195158",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.