Individual provider Active NPI

Mira Hermina Guirguis, APRN

  • Nurse Practitioner
  • Zephyrhills, FL
National Provider Identifier
1063173748
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11016375 Issued in FL
Practice address
38135 Market SQ
Zephyrhills, FL 33542-7505
Phone
(813) 780-2155
Fax
(813) 355-5017
NPI assigned
Jan 5, 2022
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11016375 FL Primary

Addresses

Primary practice location

38135 Market SQ
Zephyrhills, FL 33542-7505

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (352) 567-0188

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
I20220124001097 FL Practitioner - Nurse Practitioner 6406248517 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11016375FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Nurse Practitioner Current Accepting new patients
Cardiac Vision LLC CurrentSince Jan 7, 2022 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Jan 1, 2023 Accepting new patients

Locations

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2985 Drew St
Clearwater, FL 33759
Phone (727) 467-4860

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

6633 Forest Ave
Ste 105
New Prt Rchy, FL 34653
Phone (727) 845-4300

Interoperability endpoints

  • Direct secure messaging: mira.guirguisaprn@direct.mybaycare.org

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1063173748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-780-2155",
            "fax_number": "813-355-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIRGUIS",
        "first_name": "MIRA",
        "middle_name": "HERMINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11016375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.