Individual provider Active NPI

Annissa Irene Belfort, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami Lakes, FL
National Provider Identifier
1023824059
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11036622 Issued in FL
Practice address
14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569
Phone
(833) 769-3524
Fax
(786) 206-5877
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11036622 FL Primary

Addresses

Primary practice location

14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569

Mailing address

14645 NW 77TH Ave Ste 101
Miami Lakes, FL 33014-2569
Phone (833) 769-3524

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
I20251024003326 FL Practitioner - Nurse Practitioner 6507354065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

14645 NW 77TH Ave
Suite 101
Miami Lakes, FL 33014-2569
Phone (786) 785-9033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11036622FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

2500 NW 107th Ave
Ste 102
Doral, FL 33172
Phone (786) 605-9400

14645 NW 77th Ave
Ste 101
Miami Lakes, FL 33014
Phone (786) 785-9033

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.annissabelfort@141363.advancedmd-direct.com

Organizations & group practices 1

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": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1023824059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14645 NW 77TH AVE STE 101",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142569",
            "telephone_number": "833-769-3524",
            "fax_number": "786-206-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14645 NW 77TH AVE STE 101",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142569",
            "telephone_number": "833-769-3524",
            "fax_number": "786-206-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELFORT",
        "first_name": "ANNISSA",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11036622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.