Provider Demographics
NPI:1255789194
Name:RODRIGUEZ-CAPOTE, INES JACQUELINE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:INES
Middle Name:JACQUELINE
Last Name:RODRIGUEZ-CAPOTE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13067 N TELECOM PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9441 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34637-5837
Practice Address - Country:US
Practice Address - Phone:813-903-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9319238163W00000X
FLARNP9319238208M00000X, 363LF0000X
FLARNP 9319238364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
B8T09OtherBCBS
FL017778300Medicaid
FLIU274ZMedicare PIN
FLIU274YMedicare PIN