Individual provider Active NPI

Rafael Rodriguez Jr., DPT

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1841803640
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35873 Issued in FL
Practice address
1413 Viscaya Pkwy
Cape Coral, FL 33990-6206
Phone
(239) 242-0070
Fax
(239) 242-0076
NPI assigned
Aug 31, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT35873 FL Primary

Addresses

Primary practice location

1413 Viscaya Pkwy
Cape Coral, FL 33990-6206

Mailing address

1413 Viscaya Pkwy
Cape Coral, FL 33990-6206
Phone (239) 242-0070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210201001645 FL Practitioner - Physical Therapist in Private Practice 8921412099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT35873FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Physical Therapy, P.a. Multi-Specialty CurrentSince Jan 1, 2021 Accepting new patients
Maxider Corporation Multi-Specialty Past Accepting new patients

Locations

1469 SW 4th Ter
Cape Coral, FL 33991
Phone (234) 242-0070

1413 Viscaya Pkwy
Cape Coral, FL 33990
Phone (239) 242-0070

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1841803640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 VISCAYA PKWY",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906206",
            "telephone_number": "239-242-0070",
            "fax_number": "239-242-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 VISCAYA PKWY",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339906206",
            "telephone_number": "239-242-0070",
            "fax_number": "239-242-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.