NPIMap

Individual provider Active NPI

Rolando Dominguez Mustafa, M.D.

  • Adult Medicine Physician
  • Lake City, FL
National Provider Identifier
1508145251
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME123013 Issued in FL
Practice address
777 W Duval St
Lake City, FL 32055-5806
Phone
(386) 755-3500
NPI assigned
Aug 12, 2011
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME123013 FL Primary
Hospitalist Physician 208M00000X ME123013 FL

Addresses

Primary practice location

777 W Duval St
Lake City, FL 32055-5806

Mailing address

437 SW Rosemary Dr
Lake City, FL 32024-6715
Phone (973) 610-6389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150916002917 FL Practitioner - HospitalistPractitioner - Family Practice 0143472225 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Hospital Medicine Services of FL, LLCGroup PAC ID 9234596743, 513 clinicians
RDM Professional Services IncGroup PAC ID 8820423502, 4 clinicians

Practice addresses (Care Compare)

340 NW Commerce Dr
Lake City Medical Center
Lake City, FL 32055-4709
Phone (850) 719-9000

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

777 W Duval St
Lake City, FL 32055-5806
Phone (973) 610-6389

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.47 of 100Reported as group
Quality
95
Improvement activities
40
Cost
44.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME123013FLMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Florida IV, LLC CurrentSince Jul 25, 2025 Accepting new patients
Halifax Healthcare Systems Inc Hospitalist CurrentSince Jul 27, 2015 Accepting new patients
RDM Professional Services, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Hospital Medicine Services of FL, LLC Hospitalist CurrentSince Apr 1, 2023 Accepting new patients
Sound Physicians of Florida IV, LLC Hospitalist CurrentSince Jul 25, 2025 Accepting new patients
Envoy of Richmond, LLC Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
#10E
Daytona Beach, FL 32114

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

777 W Duval St
Lake City, FL 32055
Phone (386) 755-3300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Solaris Healthcare Lake CityLake City, FL, CCN 105769 Skilled nursing facility Adp of the SNF Jun 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1508145251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 SW ROSEMARY DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320246715",
            "telephone_number": "973-610-6389",
            "fax_number": "386-719-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W DUVAL ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320555806",
            "telephone_number": "386-755-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ MUSTAFA",
        "first_name": "ROLANDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME123013",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME123013",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.