Healthcare Provider Details

I. General information

NPI: 1275413064
Provider Name (Legal Business Name): CANDYCE PAULETTE RODRIGUEZ MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6182 N US HIGHWAY 41
APOLLO BEACH FL
33572-1802
US

IV. Provider business mailing address

3301 W GANDY BLVD
TAMPA FL
33611-2931
US

V. Phone/Fax

Practice location:
  • Phone: 813-925-1903
  • Fax:
Mailing address:
  • Phone: 813-970-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11042032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: