Individual provider Active NPI

Lilliam Perez Rodriguez, APRN

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1417528415
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11013647 Issued in FL
Practice address
110 NE 2ND PL Ste 106
Cape Coral, FL 33909-2553
Phone
(239) 244-2917
Fax
(239) 236-1991
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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 APRN11013647 FL Primary

Addresses

Primary practice location

110 NE 2ND PL Ste 106
Cape Coral, FL 33909-2553

Mailing address

110 NE 2ND PL Ste 106
Cape Coral, FL 33909-2553
Phone (239) 244-2917

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
I20230314002780 FL Practitioner - Nurse Practitioner 2365811064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

110 NE 2ND PL
Suite 106
Cape Coral, FL 33909-2553
Phone (239) 244-2917

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care Group Family CurrentSince Nov 8, 2022 Accepting new patients
LPR Professional Health Clinic Inc Family CurrentSince Sep 23, 2021 Accepting new patients

Locations

110 NE 2nd Pl
Ste 106
Cape Coral, FL 33909
Phone (239) 244-2917

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": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1417528415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 NE 2ND PL STE 106",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092553",
            "telephone_number": "239-244-2917",
            "fax_number": "239-236-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NE 2ND PL STE 106",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092553",
            "telephone_number": "239-244-2917",
            "fax_number": "239-236-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ RODRIGUEZ",
        "first_name": "LILLIAM",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11013647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.