Individual provider Active NPI

Iliana Marie Burgos Rodriguez I, DC

  • Chiropractor
  • Kissimmee, FL
National Provider Identifier
1861150294
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH13811 Issued in FL
Practice address
1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621
Phone
(404) 807-0101
NPI assigned
Dec 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH13811 FL Primary

Addresses

Primary practice location

1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621

Mailing address

1210 E Osceola Pkwy Ste 302
Kissimmee, FL 34744-1621
Phone (407) 807-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CH13811FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Isava Enterprise Inc Chiropractor Past Accepting new patients

Organizations & group practices 1

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": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1861150294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "407-807-0101",
            "fax_number": "407-807-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E OSCEOLA PKWY STE 302",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441621",
            "telephone_number": "404-807-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS RODRIGUEZ",
        "first_name": "ILIANA",
        "middle_name": "MARIE",
        "name_suffix": "I",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.