Individual provider Active NPI

Florenda De Guzman

  • Primary Care Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1023540507
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP132916 Issued in TX
Practice address
405 N Tom Green
Odessa, TX 79761
Phone
(432) 580-9876
Fax
(432) 580-9877
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP132916 TX Primary

Addresses

Primary practice location

405 N Tom Green
Odessa, TX 79761

Mailing address

1619 E Everglade Ave
Odessa, TX 79762-7916
Phone (432) 580-9876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190408001969 TX Practitioner - Nurse Practitioner 0941541593 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132916TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scotty Ortega MD LLP CurrentSince Dec 13, 2018 Accepting new patients
Doorstep Procare Management LLC CurrentSince Mar 20, 2023 Accepting new patients
Permian Women's Center, P.a PastSince Jun 16, 1997 Accepting new patients

Locations

2944 Motley Dr
Ste 401
Mesquite, TX 75150
Phone (972) 289-2273

3001 N Faudree Rd
Odessa, TX 79765
Phone (432) 332-1386

2487 E 11th St
Odessa, TX 79761
Phone (432) 332-1386

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/abd8726a-ad55-4f85-8206-9ee9deb6ac7b/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1023540507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 E EVERGLADE AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627916",
            "telephone_number": "432-580-9876",
            "fax_number": "432-580-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N TOM GREEN",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79761",
            "telephone_number": "432-580-9876",
            "fax_number": "432-580-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "FLORENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP132916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.