Individual provider Active NPI

Latasha McDuffie

  • Family Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1033969233
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11031259 Issued in FL
Practice address
6388 Silver Star Rd Ste 2H
Orlando, FL 32818-3235
Phone
(352) 205-4149
NPI assigned
Mar 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 11031259 FL Primary

Addresses

Primary practice location

6388 Silver Star Rd Ste 2H
Orlando, FL 32818-3235

Mailing address

5937 Raleigh St Apt 5416
Orlando, FL 32835-2515
Phone (864) 275-4624

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
I20250218002034 FL Practitioner - Nurse Practitioner 2163942343 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031259FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bliss Specialty Healthcare Group CurrentSince Sep 23, 2024 Accepting new patients

Locations

6388 Silver Star Rd
Ste 2H
Orlando, FL 32818
Phone (352) 205-9149

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGDFCD

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": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1033969233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5937 RALEIGH ST APT 5416",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352515",
            "telephone_number": "864-275-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6388 SILVER STAR RD STE 2H",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328183235",
            "telephone_number": "352-205-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFIE",
        "first_name": "LATASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11031259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.