DR. RENE RODRIGUEZ, MD - NPI NUMBER 1508917733

Summary

Provider Name: DR. RENE RODRIGUEZ, MD

NPI Number: 1508917733

Clasification: Internal Medicine (207R00000X)

Address:
3800 S.W. 128 AVENUE
MIRAMAR, FL
ZIP 33027

Phone Number: (954) 438-7877



Detailed Information

DR. Rene Rodriguez, MD is an internist in Miramar, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. The assigned NPI number for this provider is 1508917733 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

3800 S.W. 128 AVENUE
MIRAMAR, FL
ZIP 33027-819
Phone: (954) 438-7877
Fax: (954) 442-4449

The enumeration date for this NPI number is 1/15/2007 and was last updated on 10/9/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207R00000X Internal Medicine ME0061780 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 FLME0061780 OTHER FL FLORIDA LICENSE #
2 14834 OTHER FL BLUE CROSS OF FLORIDA
3 14834B MEDICARE ID-TYPE UNSPECIFIED FL MEDICARE #
4 251725600 MEDICAID FL
5 F25036 MEDICARE UPIN FL

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1508917733 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name RODRIGUEZ The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name RENE The first name of the provider, if the provider is an individual.
5 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
6 Provider Credential Text MD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 3800 S.W. 128 AVENUE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name MIRAMAR The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name FL The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 330272819 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 9544387877 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 9544424449 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 1/15/2007 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 10/9/2008 The date that a record was last updated or changed.
16 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 207R00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 ME0061780 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 FL The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 FLME0061780 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
22 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier State 1 FL
24 Other Provider Identifier Issuer 1 FLORIDA LICENSE #
25 Other Provider Identifier 2 14834 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 2 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier State 2 FL
28 Other Provider Identifier Issuer 2 BLUE CROSS OF FLORIDA
29 Other Provider Identifier 3 14834B Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 3 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier State 3 FL
32 Other Provider Identifier Issuer 3 MEDICARE #
33 Other Provider Identifier 4 251725600 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier Type Code 4 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
35 Other Provider Identifier State 4 FL
36 Other Provider Identifier 5 F25036 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
37 Other Provider Identifier Type Code 5 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
38 Other Provider Identifier State 5 FL
39 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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