Tresa Bietola, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11015567 Issued in FL

Practice address

2450 Hollywood Blvd Ste 701
Hollywood, FL 33020-6628

Phone

(954) 367-5316

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tresa Hagell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Complete Ketamine Solutions Hollywood LLC

  • Multi-Specialty Clinic/Center
  • Hollywood, FL
  • NPI 1295498830
  NPD
• Serenity Shift Wellness Center Inc

  • Family Nurse Practitioner
  • Hollywood, FL
  • NPI 1669265815
  NPD

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1093477895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3562 SOUTHERN ORCHARD RD W",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333286900",
            "telephone_number": "519-980-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 HOLLYWOOD BLVD STE 701",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206628",
            "telephone_number": "954-367-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIETOLA",
        "first_name": "TRESA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11015567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRESA",
            "last_name": "HAGELL",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Debra L Bichachi, LCSW
• Laureen A Biczak, DO
• Emelina Doana Biddy
• Jean Bienaime, DMFT, LCSW
• Sara Leah Bienenfeld, PA-C
• David Noel Bimston, M.D.
• Jenna Nicole Binaco
• Bio-Medical Applications of Florida, Inc.
• Kellie K Birch, CRNA
• Gary A Birken, MD

• Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, 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 8, 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.