Individual provider Active NPI

Geraldine Superville, ARNP

  • Nurse Practitioner
  • Miami, FL
National Provider Identifier
1093044265
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP3209202 Issued in FL
Practice address
4960 SW 72ND Ave
Suite 406
Miami, FL 33155-5544
Phone
(305) 662-5200
Fax
(305) 284-7948
NPI assigned
Dec 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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 ARNP3209202 FL Primary

Addresses

Primary practice location

4960 SW 72ND Ave
Suite 406
Miami, FL 33155-5544

Mailing address

4960 SW 72ND Ave
Suite 406
Miami, FL 33155-5544
Phone (305) 662-5200

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1093044265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE",
            "address_2": "SUITE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555544",
            "telephone_number": "305-662-5200",
            "fax_number": "305-284-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE",
            "address_2": "SUITE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555544",
            "telephone_number": "305-662-5200",
            "fax_number": "305-284-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERVILLE",
        "first_name": "GERALDINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3209202",
            "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 Dec 16, 2009; 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.