Individual provider Active NPI

Evelyn Rodriguez

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1376373498
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06241231 Issued in FL
Practice address
200 S Park Rd Ste 200
Hollywood, FL 33021-8541
Phone
(866) 986-2263
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06241231 FL Primary

Addresses

Primary practice location

200 S Park Rd Ste 200
Hollywood, FL 33021-8541

Mailing address

123 NW 136TH PL
Miami, FL 33182-1947
Phone (786) 338-0872

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
I20240830000677 FL Practitioner - Nurse Practitioner 5890234173 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F06241231FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Home Health Services, Inc Current Accepting new patients
Wound Technology Network Inc CurrentSince Aug 26, 2024 Accepting new patients
Integrity Home Health Services, Inc Current Accepting new patients

Locations

200 S Park Rd
Ste 200
Hollywood, FL 33021
Phone (866) 986-2263

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1376373498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 NW 136TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331821947",
            "telephone_number": "786-338-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S PARK RD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218541",
            "telephone_number": "866-986-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "EVELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F06241231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.