Individual provider Active NPI

Yadilis Hernandez Rodriguez

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1366275430
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PSW1399 Issued in FL
Practice address
6371 Collins Rd Apt 1016
Jacksonville, FL 32244-7528
Phone
(787) 203-9488
NPI assigned
Aug 23, 2024
Reactivated
Sep 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X PSW1399 FL Primary

Addresses

Primary practice location

6371 Collins Rd Apt 1016
Jacksonville, FL 32244-7528

Mailing address

6371 Collins Rd Apt 1016
Jacksonville, FL 32244-7528
Phone (787) 203-9488

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251110001367 FL Practitioner - Clinical Social Worker 9032609813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSW1399FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Oct 3, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1366275430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6371 COLLINS RD APT 1016",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447528",
            "telephone_number": "787-203-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6371 COLLINS RD APT 1016",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322447528",
            "telephone_number": "787-203-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ RODRIGUEZ",
        "first_name": "YADILIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-09-23",
        "certification_date": "2024-08-23",
        "deactivation_date": "2024-11-19",
        "reactivation_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "PSW1399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.