Individual provider Active NPI

Marlen Maria Rodriguez, MD

  • Pediatrics Physician
  • Hialeah, FL
National Provider Identifier
1306227087
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME135859 Issued in FL
Practice address
1193 W 49TH St
Hialeah, FL 33012-3337
Phone
(305) 777-9190
Fax
(305) 779-0729
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME135859 FL Primary

Addresses

Primary practice location

1193 W 49TH St
Hialeah, FL 33012-3337

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (305) 387-7211

Other identifiers 1

IdentifierTypeStateIssuer
100149400MedicaidFL

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
I20231201000067 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4284082256

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135859FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics PastSince Oct 25, 2020 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics PastSince Dec 1, 2019 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Dec 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mrodriguez@pa.trimed.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1306227087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "305-387-7211",
            "fax_number": "305-382-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 W 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123337",
            "telephone_number": "305-777-9190",
            "fax_number": "305-779-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MARLEN",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME135859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100149400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.