MEDICARE: PAULA RODRIGUEZ APN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11033568	FL
2	363LF0000X	Family Nurse Practitioner	209020944	IL

General Provider Information

NPI Number	:	1053938332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA RODRIGUEZ APN, FNP-BC

Provider Business Mailing Address
First Line	:	301 VALENCIA CT N
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33566-6714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6206 COMMERCE PALMS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1506
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	10/24/2024

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