Individual provider Active NPI

Estrella Rodriguez Fong

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1750990149
Registry record updated Feb 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11008461 Issued in FL
Practice address
4117 NE 25TH CT
Homestead, FL 33033-5172
Phone
(305) 733-8099
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11008461 FL Primary

Addresses

Primary practice location

4117 NE 25TH CT
Homestead, FL 33033-5172

Mailing address

4117 NE 25TH CT
Homestead, FL 33033-5172
Phone (305) 733-8099

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
I20260109000048 FL Order and Referring Only - Family PracticePractitioner - Family Practice 6709362791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11008461FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708214400000",
    "number": "1750990149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 NE 25TH CT",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335172",
            "telephone_number": "305-733-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 NE 25TH CT",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330335172",
            "telephone_number": "305-733-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ FONG",
        "first_name": "ESTRELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2024-02-18",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11008461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.