Individual provider Active NPI

Raquel Melendez Rodriguez, PHD

  • Clinical Child & Adolescent Psychologist
  • Orlando, FL
National Provider Identifier
1659005551
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PY10939 Issued in FL
Practice address
100 W Gore St Ste 405
Orlando, FL 32806-1049
Phone
(321) 841-9340
Fax
(321) 841-9344
NPI assigned
Jul 15, 2022
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10939 FL
Clinical Child & Adolescent Psychologist 103TC2200X PY10939 FL Primary

Addresses

Primary practice location

100 W Gore St Ste 405
Orlando, FL 32806-1049

Mailing address

100 W Gore St Ste 405
Orlando, FL 32806-1049
Phone (321) 841-9340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10939FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients

Locations

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

Interoperability endpoints

  • Direct secure messaging: rmelendezrodriguez377479@orlandohealth.medalliesdirect.net

Organizations & group practices 1

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": "1657843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1659005551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W GORE ST STE 405",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061049",
            "telephone_number": "321-841-9340",
            "fax_number": "321-841-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GORE ST STE 405",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061049",
            "telephone_number": "321-841-9340",
            "fax_number": "321-841-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELENDEZ RODRIGUEZ",
        "first_name": "RAQUEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "10939",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY10939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.