Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Lavandera Rodriguez

Individual provider Surgical Physician Assistant · NPI 1417311622

Ivan Lavandera Rodriguez is a Nurse Practitioner in Ft Lauderdale, Florida. Qualified in 2019, 7 years ago. Practices with Florida Practitioners, LLC, a 62-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1995 E Oakland Park Blvd Ste 310
Ft Lauderdale, FL 33306-1138
Phone: (954) 791-6146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 11012299 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 15-528 (FL)

Record details

NPI number1417311622
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 13, 2016
Last updated in NPPESApril 5, 2021
Certification dateApril 5, 2021
Mailing address13533 Sw 62nd St Apt 3, Miami, FL 33183-5094

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Florida Practitioners, Llc — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ft Lauderdale