Healthcare Provider Details

I. General information

NPI: 1154938199
Provider Name (Legal Business Name): NADYIBI RODRIGUEZ MENENDEZ MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 HENDERSON BLVD STE 101
TAMPA FL
33609-3900
US

IV. Provider business mailing address

3217 KING WILLIAM CIR
SEFFNER FL
33584-6143
US

V. Phone/Fax

Practice location:
  • Phone: 813-851-4531
  • Fax:
Mailing address:
  • Phone: 656-650-5514
  • Fax: 762-212-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11007098
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: