Jacqueline Elise Rodriguez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9118582 Issued in FL

Practice address

9111 Park Dr
Miami Shores, FL 33138-3159

Phone

(305) 756-6110

NPI assigned

Mar 7, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Vilmed Inc

  • Infectious Disease Physician
  • Miami Shores, FL
  • NPI 1730259649
  Medicare reassignment

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1861250631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 NE 116TH ST",
            "city": "BISCAYNE PARK",
            "state": "FL",
            "postal_code": "331616745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 PARK DR",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331383159",
            "telephone_number": "305-756-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACQUELINE",
        "middle_name": "ELISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Ripert, LMHC
• Digna I Riva, MD
• Natalie Marie Robayna
• Robin a Avery PHD PLLC
• Katina Marlova Rodriguez Rey
• Ronel Corbin Wellness Medicine Ince (Healing Elephant Acupuncture and Wellness Medicine Clinic)
• Naomi Rosenblum, RMHCI
• Ann Russoli, LCSW
• Aneisha Samuels
• Alfredo Sanchez-Fortis, M.D.

• Physician Assistant in Miami Shores, FL
• Providers in Miami Shores, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.