Active NPI
Staniesha Rodriguez
- Family Medicine Physician
- Pembroke Pines, FL
National Provider Identifier
1215535968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11009446
- Practice address
- 4341 SW 114TH Ter Apt 8406
Pembroke Pines, FL 33025-6644 - Phone
- (786) 229-5446
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11009446 | FL | Primary |
Addresses
Primary practice location
4341 SW 114TH Ter Apt 8406
Pembroke Pines, FL 33025-6644
Mailing address
4341 SW 114TH Ter Apt 8406
Pembroke Pines, FL 33025-6644
Phone (786) 229-5446
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11009446 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1215535968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4341 SW 114TH TER APT 8406",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330256644",
"telephone_number": "786-229-5446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4341 SW 114TH TER APT 8406",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330256644",
"telephone_number": "786-229-5446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "STANIESHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "11009446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.