Individual provider Active NPI

Elizabeth Rose Rodriguez, CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1396473237
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20350 Issued in FL
Practice address
6680 Bennett Creek Dr Apt 433
Jacksonville, FL 32216-0019
Phone
(850) 832-0340
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 20350 FL Primary

Addresses

Primary practice location

6680 Bennett Creek Dr Apt 433
Jacksonville, FL 32216-0019

Mailing address

6680 Bennett Creek Dr Apt 433
Jacksonville, FL 32216-0019
Phone (850) 832-0340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20350FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1396473237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6680 BENNETT CREEK DR APT 433",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160019",
            "telephone_number": "850-832-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6680 BENNETT CREEK DR APT 433",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160019",
            "telephone_number": "850-832-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELIZABETH",
        "middle_name": "ROSE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "20350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.