Individual provider Active NPI

Christopher Rodriguez, PA-C

  • Physician Assistant
  • Coral Gables, FL
National Provider Identifier
1386074359
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107375 Issued in FL
Practice address
6705 Red Road
Suite 516
Coral Gables, FL 33143-3649
Phone
(305) 403-2921
Fax
(305) 403-2928
NPI assigned
Nov 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9107375 FL Primary

Addresses

Primary practice location

6705 Red Road
Suite 516
Coral Gables, FL 33143-3649

Mailing address

6705 Red Road
Suite 516
Coral Gables, FL 33143-3649
Phone (305) 403-2921

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
I20140205000481 FL Practitioner - Physician Assistant 9830328210 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JMH Internal Medicine Specialist LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

2423 SW 147th Ave
Miami, FL 33185
Phone (305) 317-2426

1611 NW 12th Ave
Apt C150
Miami, FL 33136
Phone (305) 585-3627

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1386074359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 RED ROAD",
            "address_2": "SUITE 516",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331433649",
            "telephone_number": "305-403-2921",
            "fax_number": "305-403-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 RED ROAD",
            "address_2": "SUITE 516",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331433649",
            "telephone_number": "305-403-2921",
            "fax_number": "305-403-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.