Individual provider Active NPI

Luis M Rodriguez Gonzalez, MD

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1770504565
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1350 Issued in FL
Practice address
7747 W Hillsborough Ave
Tampa, FL 33615-4715
Phone
(813) 603-4289
Fax
(883) 393-0869
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X ACN1350 FL Primary

Addresses

Primary practice location

7747 W Hillsborough Ave
Tampa, FL 33615-4715

Mailing address

8000 SW 117TH Ave Ste 205
Miami, FL 33183-4809
Phone (786) 755-2674

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
I20220829003783 FL Practitioner - General Practice 4789606112 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shield Medical Group PLLC Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
Health First Primary Care LLC Single Specialty Past Accepting new patients
Interventional Cardiology and Vascular Consultants, P.L.C. Single Specialty PastSince Apr 1, 2022 Accepting new patients
National Medical Centers Inc Single Specialty Past Accepting new patients
Centro Especializado de Medicina Integrada Past Accepting new patients

Locations

23607 US Highway 27
Lake Wales, FL 33859
Phone (727) 522-1061

25103 US Highway 27
Lake Wales, FL 33859
Phone (863) 236-9550

4597 Casablanca Cir
Sebring, FL 33870
Phone (863) 236-9550

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJAGBA
  • Direct secure messaging: sjcluisrod@yourcarecommunity.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/BIEDBD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1770504565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 SW 117TH AVE STE 205",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834809",
            "telephone_number": "786-755-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7747 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154715",
            "telephone_number": "813-603-4289",
            "fax_number": "883-393-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.