Active NPI
Darian Dene Minzenmayer
- Prevention Professional
- Vero Beach, FL
National Provider Identifier
1013557875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- 1184124
- Practice address
- 1555 Indian River Blvd
Vero Beach, FL 32960-5639 - Phone
- (772) 778-1323
- NPI assigned
- Jan 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 1184124 | MN | Primary |
Addresses
Primary practice location
1555 Indian River Blvd
Vero Beach, FL 32960-5639
Mailing address
1555 Indian River Blvd
Vero Beach, FL 32960-5639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1184124 | MN | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1013557875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 INDIAN RIVER BLVD",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 INDIAN RIVER BLVD",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329605639",
"telephone_number": "772-778-1323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINZENMAYER",
"first_name": "DARIAN",
"middle_name": "DENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-09",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "MN",
"license": "1184124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.