Individual provider Active NPI

Rene Rodriguez, MD

  • Internal Medicine Physician
  • Miramar, FL
National Provider Identifier
1508917733
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0061780 Issued in FL
Practice address
3800 S.W. 128 Avenue
Miramar, FL 33027-2819
Phone
(954) 438-7877
Fax
(954) 442-4449
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0061780 FL Primary

Addresses

Primary practice location

3800 S.W. 128 Avenue
Miramar, FL 33027-2819

Mailing address

3800 S.W 128 Avenue
Miramar, FL 33027-2819
Phone (954) 438-7877

Other identifiers 3

IdentifierTypeStateIssuer
14834OtherFLBLUE CROSS OF FLORIDA
251725600MedicaidFL
FLME0061780OtherFLFLORIDA LICENSE #

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000722 FL Practitioner - Cardiac ElectrophysiologyPractitioner - Internal MedicinePractitioner - Emergency Medicine 9537225800 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0061780FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC CurrentSince Nov 1, 2010 Accepting new patients
Larkin Emergency Physicians LLC CurrentSince May 1, 2016 Accepting new patients
Doctors ER Services, Inc. Past Accepting new patients

Locations

651 E 25th St
Hialeah, FL 33013
Phone (305) 835-4370

1475 W 49th St
Hialeah, FL 33012
Phone (305) 824-4761

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

Organizations & group practices 3

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1508917733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S.W 128 AVENUE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272819",
            "telephone_number": "954-438-7877",
            "fax_number": "954-442-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S.W. 128 AVENUE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272819",
            "telephone_number": "954-438-7877",
            "fax_number": "954-442-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0061780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FLORIDA",
            "identifier": "14834",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251725600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE #",
            "identifier": "FLME0061780",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.