Individual provider Active NPI

Raul Alejandro Rodriguez, FNP

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1396255857
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9297017 Issued in FL
Practice address
1440 NE 8TH St
Homestead, FL 33033-4505
Phone
(305) 289-8272
Fax
(305) 938-0770
NPI assigned
Oct 10, 2017
Reactivated
May 23, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 9297017 FL Primary

Addresses

Primary practice location

1440 NE 8TH St
Homestead, FL 33033-4505

Mailing address

5350 Atlantic Ave
Delray Beach, FL 33484-8112
Phone (561) 496-6000

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
I20250318002844 FL Practitioner - Nurse Practitioner 5597997668 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9297017FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC CurrentSince Apr 15, 2025 Accepting new patients
VMFL Medical Centers LLC CurrentSince Jun 1, 2025 Accepting new patients
Conviva Medical Center Management LLC CurrentSince Mar 1, 2025 Accepting new patients
VMFL Medical Centers LLC Current Accepting new patients
Holistic Nursing Care Agency,Inc. PastSince Feb 4, 2014 Accepting new patients

Locations

5350 Atlantic Ave
Delray Beach, FL 33484
Phone (561) 496-6000

9000 NW 15th St
Unit 6
Doral, FL 33172
Phone (305) 505-7149

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

1565 W 29th St
Hialeah, FL 33012
Phone (305) 537-4110

1440 NE 8th St
Homestead, FL 33033
Phone (305) 289-8272

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

109 Royal Palm Way
Palm Beach, FL 33480

9980 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 334-3151

Interoperability endpoints

  • Direct secure messaging: raul.rodriguez.p1@direct.vivamasmedical.nextgenshare.com

Organizations & group practices 5

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1396255857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 ATLANTIC AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848112",
            "telephone_number": "561-496-6000",
            "fax_number": "561-496-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 NE 8TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330334505",
            "telephone_number": "305-289-8272",
            "fax_number": "305-938-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAUL",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "deactivation_date": "2025-05-07",
        "reactivation_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9297017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.