Individual provider Active NPI

Samantha Jo Rodriguez, CRNA

  • Certified Registered Nurse Anesthetist
  • Tampa, FL
National Provider Identifier
1750897047
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9280806 Issued in FL
Practice address
3100 E Fletcher Ave Ofc
Tampa, FL 33613-4613
Phone
(813) 971-6000
NPI assigned
Dec 21, 2017
Last updated
Nov 14, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN9280806 FL Primary

Addresses

Primary practice location

3100 E Fletcher Ave Ofc
Tampa, FL 33613-4613

Mailing address

3100 E Fletcher Ave Ofc
Tampa, FL 33613-4613

Other identifiers 1

IdentifierTypeStateIssuer
RN9280806OtherFLFLORIDA BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327001691 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274895594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (954) 393-5000

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (954) 939-5000

900 Carillon Pkwy
Suite 205
Saint Petersburg, FL 33716-1108
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN9280806FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Mar 12, 2018 Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 12, 2018 Accepting new patients

Locations

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

3100 E Fletcher Ave
Ofc
Tampa, FL 33613

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

Organizations & group practices 4

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 2

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1750897047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE OFC",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E FLETCHER AVE OFC",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134613",
            "telephone_number": "813-971-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9280806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF NURSING",
            "identifier": "RN9280806",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.