Individual provider Active NPI

Joel Anibal Marmolejos Nunez, MD

  • General Practice Physician
  • Oakland Park, FL
National Provider Identifier
1093270423
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1143 Issued in FL
Practice address
1600 W Oakland Park Blvd
Oakland Park, FL 33311-1520
Phone
(754) 200-8248
NPI assigned
Feb 11, 2019
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21226 PR
General Practice Physician 208D00000X ACN1143 FL Primary

Addresses

Primary practice location

1600 W Oakland Park Blvd
Oakland Park, FL 33311-1520

Mailing address

12171 SW 268TH St
Homestead, FL 33032-8001
Phone (786) 663-7352

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508001908 FL Practitioner - Family Practice 9739421975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN1143FLMDGeneral Practice Physician
21226PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Care of North Florida, Inc General Practice CurrentSince Apr 23, 2019 Accepting new patients
American Care of North Florida, Inc General Practice CurrentSince Apr 23, 2019 Accepting new patients
American Care of North Florida, Inc General Practice Past Accepting new patients

Locations

12171 SW 268th St
Homestead, FL 33032
Phone 30527802001020

1100 Cesery Blvd
Jacksonville, FL 32211
Phone (904) 551-5884

1918 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 389-6954

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1093270423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12171 SW 268TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330328001",
            "telephone_number": "786-663-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W OAKLAND PARK BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333111520",
            "telephone_number": "754-200-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOLEJOS NUNEZ",
        "first_name": "JOEL",
        "middle_name": "ANIBAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-11",
        "last_updated": "2024-03-05",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21226",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.