Individual provider Active NPI

Luis J. Rodriguez Colon, M.D.

  • General Practice Physician
  • Winter Haven, FL
National Provider Identifier
1730417312
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN 521 Issued in FL
Practice address
550 Pope Ave NW Ste 300
Winter Haven, FL 33881-4679
Phone
(863) 299-2636
Fax
(863) 662-5288
NPI assigned
Nov 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17791 PR
General Practice Physician 208D00000X ACN 521 FL Primary

Addresses

Primary practice location

550 Pope Ave NW Ste 300
Winter Haven, FL 33881-4679

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (321) 332-6947

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL LRodriguez@rayparmed.com Direct

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
I20191007003673 FL Practitioner - General Practice 7618150194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Physicians LLCGroup PAC ID 9234554643, 30 clinicians

Practice addresses (Care Compare)

3240 S Florida Ave
Suite 105
Lakeland, FL 33803-4574
Phone (863) 644-7337

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17791PRMDAssistant Behavior Analyst
ACN 521FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Physicians, LLC CurrentSince Nov 1, 2020 Accepting new patients
Orlando Family Physicians, LLC General Practice Past Accepting new patients

Locations

3240 S Florida Ave
Ste 105
Lakeland, FL 33803
Phone (863) 644-7337

3240 S Florida Ave
Ste 101
Lakeland, FL 33803
Phone (863) 644-7337

3240 S Florida Ave
Ste 100
Lakeland, FL 33803
Phone (863) 646-4000

425 W Colonial Dr
Ste 303
Orlando, FL 32804
Phone (321) 332-6947

6900 Tavistock Lakes Blvd
Ste 300
Orlando, FL 32827
Phone (321) 332-6947

550 Pope Ave NW
Ste 300
Winter Haven, FL 33881
Phone (863) 299-2636

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: luis.rodriguez-colon.1@27472.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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1730417312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "321-332-6947",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 POPE AVE NW STE 300",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814679",
            "telephone_number": "863-299-2636",
            "fax_number": "863-662-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ COLON",
        "first_name": "LUIS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17791",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LRodriguez@rayparmed.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "550 Pope Ave NW",
            "city": "Winter Haven",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338814679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.