Individual provider Active NPI

Susana Hernandez Tamayo, APRN

  • Family Nurse Practitioner
  • Sunny Isles Beach, FL
National Provider Identifier
1023830536
Registry record updated Oct 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11036208 Issued in FL
Practice address
19380 Collins Ave Apt 1510
Sunny Isles Beach, FL 33160-2238
Phone
(813) 356-9465
NPI assigned
Oct 26, 2024
Last updated
Oct 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11036208 FL Primary

Addresses

Primary practice location

19380 Collins Ave Apt 1510
Sunny Isles Beach, FL 33160-2238

Mailing address

19380 Collins Ave Apt 1510
Sunny Isles Beach, FL 33160-2238
Phone (813) 356-9465

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
I20250730002746 FL Practitioner - Nurse Practitioner 3476060757 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11036208FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Comprehensive Urgent Care, LLC. CurrentSince Jul 1, 2025 Accepting new patients
Integrated Comprehensive Urgent Care LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

3595 W 20th Ave
Ste 130
Hialeah, FL 33012
Phone (305) 456-7951

8700 SW 88th St
Ste 100
Miami, FL 33176
Phone (305) 271-1515

9400 NW 12th Ave
#6
Miami, FL 33150
Phone (305) 779-0040

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1729900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1023830536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19380 COLLINS AVE APT 1510",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602238",
            "telephone_number": "813-356-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19380 COLLINS AVE APT 1510",
            "city": "SUNNY ISLES BEACH",
            "state": "FL",
            "postal_code": "331602238",
            "telephone_number": "813-356-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ TAMAYO",
        "first_name": "SUSANA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-26",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11036208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunny Isles Beach, FL

Sources for this page

Verify at the official NPI Registry.