Individual provider Active NPI

Miriam Jocelyn Rodriguez, PHD

  • Clinical Neuropsychologist
  • Doral, FL
National Provider Identifier
1619398419
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PY9391 Issued in FL
Practice address
2173 NW 99TH Ave
Doral, FL 33172-2231
Phone
(305) 593-1223
NPI assigned
Dec 20, 2013
Last updated
Apr 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY9391 FL Primary

Addresses

Primary practice location

2173 NW 99TH Ave
Doral, FL 33172-2231

Mailing address

2173 NW 99TH Ave
Doral, FL 33172-2231
Phone (305) 593-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200108002911 FL Practitioner - Clinical Psychologist 2567897101 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY9391FLMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Miriam J Rodriguez, LLC Current Accepting new patients
Bird of Paradise Psychological Services PA CurrentSince Aug 7, 2019 Accepting new patients

Locations

4300 N University Dr
Ste C203
Lauderhill, FL 33351
Phone (954) 742-5800

7051 W Commercial Blvd
Ste 3A
Lauderhill, FL 33319
Phone (954) 720-0412

Interoperability endpoints

  • Direct secure messaging: miriam.rodriguez.1@30520.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1619398419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2173 NW 99TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722231",
            "telephone_number": "305-593-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 NW 99TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722231",
            "telephone_number": "305-593-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "MIRIAM",
        "middle_name": "JOCELYN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-20",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY9391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.