Individual provider Active NPI

Elizabeth Rodriguez

  • Nurse Practitioner
  • Davie, FL
National Provider Identifier
1972128015
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11007381 Issued in FL
Practice address
4217 SW 64TH Ave Ste 1
Davie, FL 33314-3446
Phone
(954) 432-1812
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11007381 FL Primary

Addresses

Primary practice location

4217 SW 64TH Ave Ste 1
Davie, FL 33314-3446

Mailing address

4217 SW 64TH Ave Ste 1
Davie, FL 33314-3446
Phone (954) 432-1812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200624001826 FL Practitioner - Nurse Practitioner 9133541923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mason Hershorin MSN Arnp Inc.Group PAC ID 4789685777, 3 clinicians

Practice addresses (Care Compare)

2728 SE 16TH PL
Cape Coral, FL 33904-3209
Phone (239) 573-7598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mason Hershorin MSN Arnp Inc. Nurse Practitioner CurrentSince May 19, 2020 Accepting new patients
Integrated-1 Corp Past Accepting new patients

Locations

2728 SE 16th Pl
Cape Coral, FL 33904
Phone (239) 573-7598

4801 S University Dr
Ste 217
Davie, FL 33328
Phone (954) 432-1812

4217 SW 64th Ave
Ste 1
Davie, FL 33314
Phone (954) 432-1812

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1972128015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 SW 64TH AVE STE 1",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143446",
            "telephone_number": "954-432-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 SW 64TH AVE STE 1",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143446",
            "telephone_number": "954-432-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11007381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.