Individual provider Active NPI

Carlos Miguel Martinez Costa, FNP

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1114635919
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022982 Issued in FL
Practice address
1072 W 64TH St
Hialeah, FL 33012-6417
Phone
(786) 630-3894
Fax
(786) 534-4540
NPI assigned
Nov 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APRN11022982 FL Primary

Addresses

Primary practice location

1072 W 64TH St
Hialeah, FL 33012-6417

Mailing address

1072 W 64TH St
Hialeah, FL 33012-6417
Phone (786) 630-3894

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240322002411 FL Practitioner - Nurse Practitioner 0244677482 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Medcare LLC Single Specialty CurrentSince Sep 4, 2024 Accepting new patients
Comfort Medical Care LLC Single Specialty CurrentSince Jan 8, 2024 Accepting new patients

Locations

5881 NW 151st St
Ste 106
Miami Lakes, FL 33014
Phone (305) 818-2004

14100 Palmetto Frntg Rd
Ste 105
Miami Lakes, FL 33016
Phone (786) 205-6161

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAJFDD/Endpoint/IAJFDD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1114635919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 W 64TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126417",
            "telephone_number": "786-630-3894",
            "fax_number": "786-534-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 W 64TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330126417",
            "telephone_number": "786-630-3894",
            "fax_number": "786-534-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ COSTA",
        "first_name": "CARLOS",
        "middle_name": "MIGUEL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-10",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.