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YAIRALIZ RODRIGUEZ GONZALEZ
NPI 1104321348
General Practice in Lake Wales, FL

Active since March 29, 2018PECOS EnrolledAccepts Medicare Assignment
684 STATE ROAD 60 W, LAKE WALES, FL 33853(863) 949-4868 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 12, 2025, Jul 27, 2021, Mar 29, 2018 (3 updates tracked since 2018).

About Yairaliz Rodriguez Gonzalez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YAIRALIZ RODRIGUEZ GONZALEZ (NPI 1104321348) is an individual general practice provider in Lake Wales, Florida, licensed in Florida (ACN1500) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1104321348
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameYAIRALIZ RODRIGUEZ GONZALEZ
Location Address684 STATE ROAD 60 WLake Wales, FL 33853-4419
Mailing Address684 State Road 60 WLake Wales, FL 33853-4419 · (863) 949-4868
Phone(863) 949-4868
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 29, 2018
Last NPPES UpdateFebruary 12, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2026
✔ NPI 1104321348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in FL · ACN1500✔ Licensed in PR · 22144
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
684 STATE ROAD 60 W, Lake Wales, FL 33853
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Other Identifiers 2

Other14673PR · Mmc
Medicaid22144PR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Yairaliz Rodriguez Gonzalez is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618370651
PECOS Enrollment IDI20230727003305
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATASHA L FENELON APRN
Nurse Practitioner (Family)
684 STATE ROAD 60 W
LAKE WALES, FL 33853
Polk County (863) 949-4868
DR. DANICE BLAISE MD,MBA
General Practice
684 STATE ROAD 60 W
LAKE WALES, FL 33853
Polk County (863) 949-4868
MEDICAL HOME ALLIANCE LLC
Internal Medicine
684 STATE ROAD 60 W
LAKE WALES, FL 33853
Polk County (863) 949-4868

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yairaliz Rodriguez Gonzalez's NPI number?

The NPI number for Yairaliz Rodriguez Gonzalez is 1104321348. It was assigned to this individual provider in the NPPES registry on March 29, 2018.

Where is Yairaliz Rodriguez Gonzalez located?

Yairaliz Rodriguez Gonzalez practices at 684 State Road 60 W, Lake Wales, FL 33853. The listed phone number is (863) 949-4868.

What is Yairaliz Rodriguez Gonzalez's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Yairaliz Rodriguez Gonzalez enrolled in Medicare?

Yes. Yairaliz Rodriguez Gonzalez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Yairaliz Rodriguez Gonzalez accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Yairaliz Rodriguez Gonzalez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Yairaliz Rodriguez Gonzalez was last updated on February 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.