Individual provider Active NPI

Elizabeth Bauza Estrada

  • Family Nurse Practitioner
  • Deltona, FL
National Provider Identifier
1003465527
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11003628 Issued in FL
Practice address
1409 E Hancock Dr
Deltona, FL 32725-6443
Phone
(786) 259-3944
NPI assigned
Sep 6, 2019
Last updated
Apr 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11003628 FL
Family Nurse Practitioner 363LF0000X APRN11003628 FL Primary
Primary Care Nurse Practitioner 363LP2300X 11003628 FL

Addresses

Primary practice location

1409 E Hancock Dr
Deltona, FL 32725-6443

Mailing address

1409 E Hancock Dr
Deltona, FL 32725-6443
Phone (786) 259-3944

Other practice location 1

1155 W 77th St Apt 312C
Hialeah, FL 33014-3943
Phone (786) 259-3944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524000322 FL Practitioner - Nurse Practitioner 1052798451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Primary Physicians LLCGroup PAC ID 0840377610, 3 clinicians

Practice addresses (Care Compare)

1565 Saxon Blvd
Suite 103
Deltona, FL 32725-5823
Phone (386) 574-1423

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11003628FLMDFamily Nurse Practitioner
11003628FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Primary Physicians LLC CurrentSince Mar 24, 2024 Accepting new patients
Lahens Medical Center, Inc. CurrentSince Feb 12, 2022 Accepting new patients
Central Florida Primary Physicians CurrentSince Mar 24, 2024 Accepting new patients

Locations

1565 Saxon Blvd
Ste 103
Deltona, FL 32725
Phone (386) 574-1423

1140 S Semoran Blvd
Ste E
Orlando, FL 32807
Phone (407) 384-9165

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDFBA/Endpoint/EJDFBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1003465527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 E HANCOCK DR",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327256443",
            "telephone_number": "786-259-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E HANCOCK DR",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327256443",
            "telephone_number": "786-259-3944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 W 77th St Apt 312C",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330143943",
            "country_code": "US",
            "telephone_number": "786-259-3944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUZA ESTRADA",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003628",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003628",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11003628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

Verify at the official NPI Registry.