Active NPI
Ileana Rodriguez
- Pharmacist
- Jensen Beach, FL
National Provider Identifier
1902606684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS24139
- Practice address
- 1255 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7221 - Phone
- (772) 225-9800
- NPI assigned
- Mar 13, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS24139 | FL | Primary |
Addresses
Primary practice location
1255 NE Jensen Beach Blvd
Jensen Beach, FL 34957-7221
Mailing address
12581 SW Laguna Reef Dr
Port St Lucie, FL 34987-6936
Phone (201) 674-0999
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 |
|---|---|---|---|
| PS24139 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | 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": "1741824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741824000000",
"number": "1902606684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12581 SW LAGUNA REEF DR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349876936",
"telephone_number": "201-674-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 NE JENSEN BEACH BLVD",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349577221",
"telephone_number": "772-225-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ILEANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-13",
"last_updated": "2025-03-13",
"certification_date": "2025-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS24139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jensen Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.