Individual provider Active NPI

Carla Fazio, APRN

  • Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1013348085
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9359211 Issued in FL
Practice address
1309 N Flagler Dr
West Palm Beach, FL 33401-3406
Phone
(561) 366-4100
Fax
(561) 366-4189
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9359211 FL Primary

Addresses

Primary practice location

1309 N Flagler Dr
West Palm Beach, FL 33401-3406

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
010747500MedicaidFL

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
I20140320000204 FL Practitioner - Nurse Practitioner 5991936700 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosurg LLC CurrentSince Dec 29, 2013 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Nov 28, 2022 Accepting new patients
University of Miami Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients

Locations

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

4300 Alton Rd
Miami Beach, FL 33140
Phone (305) 481-9776

4302 Alton Rd
Ste 810
Miami Beach, FL 33140
Phone (305) 531-6766

1309 N Flagler Dr
Fl Cancer
West Palm Beach, FL 33401

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71720

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1013348085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013406",
            "telephone_number": "561-366-4100",
            "fax_number": "561-366-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "CARLA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9359211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010747500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.