Elsa Milagros Agurto Guanzon
Individual provider Active NPI Nurse Practitioner · Brandon, FL
NPI 1063995751 · NPPES record last updated Sep 21, 2020
Key facts
- NPI
- 1063995751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 9198265 (FL)
- Practice address
- 621 W Lumsden Rd
Brandon, FL 33511-5911 - Phone
- (813) 755-3500
- Fax
- (813) 755-3300
- NPI assigned
- Sep 10, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.07 of 100
- Quality
- 76.33
- Improvement activities
- 40
- Cost
- 78.47
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190710000232 | FL | Practitioner - Nurse Practitioner | 0244565596 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9198265 | FL | MD | Nurse Practitioner |
Practice roles (2 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunshine Pulmonary and Sleep Medicine P.a. | Current |
Accepting new patients | |
| Heart Vascular and Vein of Tampa Bay LLC | Current |
Accepting new patients |
Locations
621 W Lumsden Rd
Brandon, FL 33511
Phone (813) 655-1100
10141 Big Bend Rd
Ste 201
Riverview, FL 33578
Phone (813) 684-3707
1901 Haverford Ave
Ste 111
Sun City Ctr, FL 33573
Phone (727) 231-0846
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 9198265 | FL | Yes |
Addresses
Primary practice location
621 W Lumsden Rd
Brandon, FL 33511-5911
Mailing address
621 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 755-3500
Other practice location 1
635 Eichenfeld Dr
Brandon, FL 33511
Phone (813) 684-6000
Other providers in Brandon, FL
- Katlyn Megan Agosta
- Natalie Aguilera
- Alma Patricia Aguirre
- Shelizbet Aguirre
- Teresa Aguirre
- Diana C Aibar
- Bourne Chidi Ajoku
- Akery Massage Therapy Clinic, Inc.
- Kimberly Faye Akery-Lopresti
- Amy L Akery
All providers in Brandon, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.