Active NPI
Nelly Jengo, LMT
- Specialist
- Miami Gardens, FL
National Provider Identifier
1093030942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA 52209
- Practice address
- 18942 NW 46TH Ave
Miami Gardens, FL 33055-2659 - Phone
- (786) 222-4640
- NPI assigned
- Apr 5, 2010
- Last updated
- Apr 5, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA 52209 | FL | Primary |
Addresses
Primary practice location
18942 NW 46TH Ave
Miami Gardens, FL 33055-2659
Mailing address
18942 NW 46 Avenue
Miami, FL 33055-2659
Phone (786) 222-4640
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA 52209 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270425600000",
"number": "1093030942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18942 NW 46 AVENUE",
"city": "MIAMI",
"state": "FL",
"postal_code": "330552659",
"telephone_number": "786-222-4640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18942 NW 46TH AVE",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330552659",
"telephone_number": "786-222-4640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENGO",
"first_name": "NELLY",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-05",
"last_updated": "2010-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA 52209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.