Individual provider Active NPI

Odette Mireya Vazquez-Rojas, MD

  • General Practice Physician
  • Longwood, FL
National Provider Identifier
1326219767
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME103485 Issued in FL
Practice address
521 W State Road 434 Ste 101
Pediatric&Adolescent Med of Seminole, in Assoc With Nem
Longwood, FL 32750-4952
Phone
(407) 830-5437
Fax
(407) 830-4907
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME103485 FL
General Practice Physician 208D00000X ME103485 FL Primary

Addresses

Primary practice location

521 W State Road 434 Ste 101
Pediatric&Adolescent Med of Seminole, in Assoc With Nem
Longwood, FL 32750-4952

Mailing address

PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (904) 697-4203

Other identifiers 1

IdentifierTypeStateIssuer
001325400MedicaidFL

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
I20111004000431 FL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2961674593

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health Alliance, LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ovazquezrojas61111@direct.nemours.org

Organizations & group practices 1

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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1326219767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "904-697-4203",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W STATE ROAD 434 STE 101",
            "address_2": "PEDIATRIC&ADOLESCENT MED OF SEMINOLE, IN ASSOC WITH NEM",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504952",
            "telephone_number": "407-830-5437",
            "fax_number": "407-830-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ-ROJAS",
        "first_name": "ODETTE",
        "middle_name": "MIREYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME103485",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME103485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001325400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.