MEDICARE: MRS. TARA LYNN RODRIGUEZ FNP

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	APRN11045753	FL

General Provider Information

NPI Number	:	1598611451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA LYNN RODRIGUEZ FNP

Provider Business Mailing Address
First Line	:	11181 HEALTH PARK BLVD STE 1115
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-5742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6376 PINE RIDGE RD UNIT 460
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3928
Country	:	US
Telephone Number	:	239-597-4440
Fax Number	:

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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