Individual provider Active NPI

Tracy Annette Rodriguez-Miller, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1700895679
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7766 Issued in FL
Practice address
522 SW 19TH Ter
Fort Lauderdale, FL 33312-1596
Phone
(305) 676-4769
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW003832 GA
Clinical Social Worker 1041C0700X SW7766 FL Primary

Addresses

Primary practice location

522 SW 19TH Ter
Fort Lauderdale, FL 33312-1596

Mailing address

1314 E Las Olas Blvd # 1809
Fort Lauderdale, FL 33301-2334
Phone (305) 676-4769

Other names 1

  • Tracy Annette Rodriguez Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW003832GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1700895679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E LAS OLAS BLVD # 1809",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012334",
            "telephone_number": "305-676-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 SW 19TH TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121596",
            "telephone_number": "305-676-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-MILLER",
        "first_name": "TRACY",
        "middle_name": "ANNETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003832",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "RODRIGUEZ",
            "middle_name": "ANNETTE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.