Active NPI
Andrea Rodriguez Jimenez
- Internal Medicine Physician
- Lakeland, FL
National Provider Identifier
1902597339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 39236
- Practice address
- 1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543 - Phone
- (186) 368-7110
- NPI assigned
- May 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | PR | ||
| Internal Medicine Physician | 207R00000X | 39236 | FL | Primary |
Addresses
Primary practice location
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Mailing address
Urb. Villa Toledo Street Urogallo
222
Arecibo, PR 00612
Phone (787) 690-2818
Other practice location 1
Atenas Ct
Manati, PR 00674-9525
Phone (787) 840-2575 ext. 5771
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39236 | FL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1902597339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. VILLA TOLEDO STREET UROGALLO",
"address_2": "222",
"city": "ARECIBO",
"state": "PR",
"postal_code": "00612",
"telephone_number": "787-690-2818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338054543",
"telephone_number": "186-368-7110"
}
],
"practiceLocations": [
{
"address_1": "Atenas Ct",
"address_purpose": "LOCATION",
"city": "Manati",
"state": "PR",
"postal_code": "006749525",
"country_code": "US",
"telephone_number": "787-840-2575 x5771",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ JIMENEZ",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-17",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "39236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.