Individual provider Active NPI

Suzanne Marie Rodriguez, FNP-C

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1306422340
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012183 Issued in FL
Practice address
4315 Highland Park Blvd Ste a
Lakeland, FL 33813-1639
Phone
(863) 816-5884
NPI assigned
Mar 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 11012183 FL Primary

Addresses

Primary practice location

4315 Highland Park Blvd Ste a
Lakeland, FL 33813-1639

Mailing address

4315 Highland Park Blvd
Lakeland, FL 33813-1639
Phone (863) 816-5884

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210428001039 FL Practitioner - Nurse Practitioner 0547678708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

1507 S Tuttle Ave
Sarasota, FL 34239-2608
Phone (732) 552-8922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11012183FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Hospitalists PL Multi-Specialty CurrentSince Apr 20, 2021 Accepting new patients
Mana Health Partners PA Multi-Specialty CurrentSince Feb 1, 2024 Accepting new patients
Careconnectmd Florida P.a. Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Sanative Medical Group PLLC Multi-Specialty PastSince Aug 14, 2022 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

702 S Kings Ave
Brandon, FL 33511
Phone (813) 651-1818

4315 Highland Park Blvd
Lakeland, FL 33813
Phone (863) 255-4777

4315 Highland Park Blvd
Ste A
Lakeland, FL 33813
Phone (813) 651-1085

4315 Highland Park Blvd
Ste D
Lakeland, FL 33813
Phone (863) 816-5884

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

1317 Edgewater Dr
Orlando, FL 32804
Phone (877) 436-8527

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

Organizations & group practices 4

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": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1306422340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131639",
            "telephone_number": "863-816-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 HIGHLAND PARK BLVD STE A",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131639",
            "telephone_number": "863-816-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-21",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.