NPIMap

Individual provider Active NPI

Gerardo J Rodriguez, MD

  • Specialist
  • Mount Dora, FL
National Provider Identifier
1346292620
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME00064748 Issued in FL
Practice address
3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228
Phone
(352) 383-1245
Fax
(352) 383-4401
NPI assigned
May 16, 2006
Last updated
May 19, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME00064748 FL Primary

Addresses

Primary practice location

3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228

Mailing address

3801 N Highway 19a
Suite 400
Mount Dora, FL 32757-2228
Phone (352) 383-1245

Other identifiers 2

IdentifierTypeStateIssuer
3775810000MedicaidFL
377581001MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000793 FL Practitioner - Nephrology 0345139564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3801 N Hwy 19a
Suite 400
Mount Dora, FL 32757-2228
Phone (352) 383-1245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME00064748FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Diseases of the Kidney & Hypertension Inc Specialist Current Accepting new patients

Locations

611 W Dixie Ave
Leesburg, FL 34748
Phone (352) 323-0044

3801 N Highway 19A
Ste 400
Mount Dora, FL 32757
Phone (352) 383-1245

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: rrodriguez@nephrologylakeco.gwaydirect.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1346292620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N HIGHWAY 19A",
            "address_2": "SUITE 400",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572228",
            "telephone_number": "352-383-1245",
            "fax_number": "352-383-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GERARDO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME00064748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3775810000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377581001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Dora, FL

Sources for this page

Verify at the official NPI Registry.