Individual provider Active NPI

Renato De la Flor

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1083297766
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012440 Issued in FL
Practice address
6161 Blue Lagoon Dr
Miami, FL 33126-2057
Phone
(786) 388-1400
Fax
(786) 388-1401
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 11012440 FL Primary

Addresses

Primary practice location

6161 Blue Lagoon Dr
Miami, FL 33126-2057

Mailing address

6750 SW 15TH St
Miami, FL 33144-5508
Phone (786) 203-0604

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11012440FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1083297766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 SW 15TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331445508",
            "telephone_number": "786-203-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 BLUE LAGOON DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262057",
            "telephone_number": "786-388-1400",
            "fax_number": "786-388-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA FLOR",
        "first_name": "RENATO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012440",
            "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 Apr 30, 2021; 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.