Individual provider Active NPI

Vicente A Rodriguez, MD

  • General Practice Physician
  • North Miami Beach, FL
National Provider Identifier
1598868903
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME54106 Issued in FL
Practice address
1 NE 167TH St
North Miami Beach, FL 33162-3402
Phone
(305) 432-9565
Fax
(305) 432-9567
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME54106 FL Primary

Addresses

Primary practice location

1 NE 167TH St
North Miami Beach, FL 33162-3402

Mailing address

1 NE 167TH St
North Miami Beach, FL 33162-3402
Phone (305) 432-9565

Other identifiers 1

IdentifierTypeStateIssuer
062015700MedicaidFL

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
I20100419000729 FL Practitioner - General Practice 0547397887 Reassigns benefits to 2 organizations
Practice locations: Hialeah, FL

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medway Medical Centers of Clearwater LLC CurrentSince Jul 2, 2024 Accepting new patients
Medway Medical Centers LLC CurrentSince Sep 23, 2024 Accepting new patients

Locations

1012 Druid Rd E
Clearwater, FL 33756
Phone (727) 443-4242

4802 Grand Blvd
New Prt Rchy, FL 34652
Phone (727) 848-0106

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1598868903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NE 167TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623402",
            "telephone_number": "305-432-9565",
            "fax_number": "305-432-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NE 167TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331623402",
            "telephone_number": "305-432-9565",
            "fax_number": "305-432-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "VICENTE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME54106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062015700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.