Individual provider Active NPI

Luz Marina Racedo-Martin

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1053814806
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9244232 Issued in FL
Practice address
11925 Bird Dr
Miami, FL 33175-3571
Phone
(305) 467-4442
NPI assigned
Mar 16, 2018
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 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 APRN9244232 FL Primary

Addresses

Primary practice location

11925 Bird Dr
Miami, FL 33175-3571

Mailing address

121 S Orange Ave Ste 940
Orlando, FL 32801-3234
Phone (407) 658-9687

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9244232FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sandiego Medical Service Inc. Family CurrentSince Dec 29, 2024 Accepting new patients
Quality Services Home Health Inc PastSince Jan 8, 2007 Accepting new patients
Idelis Fedeslinda Arias de la Torre PastSince Jun 1, 2021 Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients

Organizations & group practices 4

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": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1053814806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S ORANGE AVE STE 940",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013234",
            "telephone_number": "407-658-9687",
            "fax_number": "407-286-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11925 BIRD DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753571",
            "telephone_number": "305-467-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACEDO-MARTIN",
        "first_name": "LUZ MARINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9244232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.