Individual provider Active NPI

Angela Maria Rodriguez, MD

  • Family Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1265633903
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME103196 Issued in FL
Practice address
1330 Riverland Rd
Fort Lauderdale, FL 33312-2961
Phone
(954) 321-9826
Fax
(954) 321-9660
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME103196 FL Primary

Addresses

Primary practice location

1330 Riverland Rd
Fort Lauderdale, FL 33312-2961

Mailing address

PO Box 11892
Fort Lauderdale, FL 33339-1892
Phone (954) 542-5832

Other identifiers 2

IdentifierTypeStateIssuer
001449400MedicaidFL
P00769977OtherFLRAILROAD MEDICARE

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
I20240514000665 FL Order and Referring Only - Family PracticePractitioner - Family Practice 1759435803

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1265633903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11892",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333391892",
            "telephone_number": "954-542-5832",
            "fax_number": "954-351-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 RIVERLAND RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122961",
            "telephone_number": "954-321-9826",
            "fax_number": "954-321-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANGELA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME103196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001449400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00769977",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.