Individual provider Active NPI

Felice Etienne Haake, D.O.

  • Family Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1093943128
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS13084 Issued in FL
Practice address
5089 Jimmy Buffet Memorial Hwy
Vero Beach, FL 32963
Phone
(772) 226-5646
Fax
(772) 873-7074
NPI assigned
Jun 26, 2009
Last updated
May 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS13084 FL Primary
Obesity Medicine (Family Medicine) Physician 207QB0002X OS13084 FL

Addresses

Primary practice location

5089 Jimmy Buffet Memorial Hwy
Vero Beach, FL 32963

Mailing address

5089 Jimmy Buffet Memorial Hwy
Vero Beach, FL 32963
Phone (772) 226-5646

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
I20160302000942 FL Practitioner - Family Practice 9739345273 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS13084FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Health Services Inc CurrentSince Jan 18, 2016 Accepting new patients
Indian River Health Services Inc CurrentSince Jan 18, 2016 Accepting new patients
Vero Orthopaedics II PA PastSince Aug 28, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

3450 11th Ct
Ste 201
Vero Beach, FL 32960
Phone (772) 794-3364

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1093943128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 JIMMY BUFFET MEMORIAL HWY",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32963",
            "telephone_number": "772-226-5646",
            "fax_number": "772-873-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5089 JIMMY BUFFET MEMORIAL HWY",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32963",
            "telephone_number": "772-226-5646",
            "fax_number": "772-873-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKE",
        "first_name": "FELICE",
        "middle_name": "ETIENNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13084",
            "primary": true
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "FL",
            "license": "OS13084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.