Individual provider Active NPI

Christopher Patino

  • Gerontology Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1053895078
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN9348711 Issued in FL
Practice address
2030 S Douglas Rd Ste 201
Coral Gables, FL 33134-4615
Phone
(786) 882-2261
NPI assigned
Sep 17, 2018
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 9348711 FL
Gerontology Nurse Practitioner 363LG0600X APRN9348711 FL Primary

Addresses

Primary practice location

2030 S Douglas Rd Ste 201
Coral Gables, FL 33134-4615

Mailing address

18741 NW 24TH CT
Pembroke Pines, FL 33029-5352

Other practice location 1

14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647
Phone (305) 698-4000

Other identifiers 1

IdentifierTypeStateIssuer
115558700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9348711FLMDAdult Health Nurse Practitioner
APRN9348711FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Med Group Corp Multi-Specialty CurrentSince Aug 15, 2022 Accepting new patients
Assured Medical LLC Single Specialty CurrentSince Apr 25, 2021 Accepting new patients
Life Wellness Group Multi-Specialty CurrentSince Dec 10, 2023 Accepting new patients

Locations

14261 Commerce Way
Ste 203
Miami Lakes, FL 33016
Phone (305) 698-4000

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, 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": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1053895078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18741 NW 24TH CT",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330295352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S DOUGLAS RD STE 201",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344615",
            "telephone_number": "786-882-2261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14261 Commerce Way Ste 203",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330161647",
            "country_code": "US",
            "telephone_number": "305-698-4000",
            "fax_number": "305-698-4014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATINO",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-17",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9348711",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9348711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115558700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.