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Individual provider Active NPI

Gloria Rodriguez Rodriguez, FNP

  • Family Nurse Practitioner
  • Moore Haven, FL
National Provider Identifier
1821473901
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9389070 Issued in FL
Practice address
1021 Health Park Dr
Moore Haven, FL 33471-6206
Phone
(863) 946-0405
Fax
(844) 542-8959
NPI assigned
Jul 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 ARNP9389070 FL Primary

Addresses

Primary practice location

1021 Health Park Dr
Moore Haven, FL 33471-6206

Mailing address

5827 Corporate Way
West Palm Beach, FL 33407-2000
Phone (561) 844-9443

Other names 1

  • Gloria Mayerly Rodriguez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161128000875 FL Practitioner - Nurse Practitioner 6103105648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Community Health Centers IncGroup PAC ID 9931017126, 32 clinicians

Practice addresses (Care Compare)

1505 Delaware Ave
Fort Pierce, FL 34950-3975
Phone (772) 461-1402

315 S W C Owen Ave
Clewiston, FL 33440-3637
Phone (863) 983-7813

Hospital & facility affiliations

  • Hendry Regional Medical Center Hospital, Clewiston, FL, CCN 101309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc CurrentSince Jul 1, 2022 Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers Inc Current Accepting new patients
Florida Community Health Centers, Inc. CurrentSince Jul 1, 2022 Accepting new patients

Locations

315 S W C Owen Ave
Clewiston, FL 33440
Phone (561) 996-9573

1505 Delaware Ave
Fort Pierce, FL 34950
Phone (772) 461-1140

15858 SW Warfield Blvd
Indiantown, FL 34956
Phone (772) 597-3596

1100 N Parrott Ave
Okeechobee, FL 34972
Phone (863) 763-1951

3235 SW Port St Lucie Blvd
Ste 105
Port St Lucie, FL 34953
Phone (772) 408-5063

5827 Corporate Way
West Palm Beach, FL 33407
Phone (561) 844-9443

Interoperability endpoints

  • Direct secure messaging: gloria.rodriguez.1@14865.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1821473901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5827 CORPORATE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072000",
            "telephone_number": "561-844-9443",
            "fax_number": "561-472-9692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 HEALTH PARK DR",
            "city": "MOORE HAVEN",
            "state": "FL",
            "postal_code": "334716206",
            "telephone_number": "863-946-0405",
            "fax_number": "844-542-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ RODRIGUEZ",
        "first_name": "GLORIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9389070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "RODRIGUEZ",
            "middle_name": "MAYERLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moore Haven, FL

Sources for this page

Verify at the official NPI Registry.