Khristel A. Fonseca-Miller, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11003880 Issued in FL

Practice address

2100 Via Bella Blvd Ste 201
Land O Lakes, FL 34639-5429

Phone

(813) 872-1234

Fax

(813) 355-5066

NPI assigned

Sep 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Medical Clinic LLC

  • Clinic/Center
  • Zephyrhills, FL
  • NPI 1821055690
  Medicare reassignment NPD
• Ohi West Medical Group II LLC

  • General Practice Physician
  • Zephyrhills, FL
  • NPI 1982381299
  Medicare reassignment NPD
• Florida Medical Clinic, LLC

  • Pharmacy
  • Zephyrhills, FL
  • NPI 1669548020
  NPD
• Ohi West Medical Group II LLC

  • Durable Medical Equipment & Medical Supplies
  • Wesley Chapel, FL
  • NPI 1427814847
  NPD

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1093364481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "352-567-0188",
            "fax_number": "813-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 VIA BELLA BLVD STE 201",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346395429",
            "telephone_number": "813-872-1234",
            "fax_number": "813-355-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA-MILLER",
        "first_name": "KHRISTEL",
        "middle_name": "A.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11003880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Medical Clinic, LLC
• Florida Wound Care Services LLC
• Floridasleep LLC
• Albert Christian Flowers, M.D.
• Cheryl Flynn
• Hector Fontanet, MD
• For the Love of You, LLC
• Angela Dawn Foretich, MA
• Sandy L. Foronda
• Alyssa Fraczek, APRN

• Nurse Practitioner in Land O Lakes, FL
• Providers in Land O Lakes, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.