Individual provider Active NPI

Myrdentz Paul, R. N.

  • Registered Nurse
  • Doral, FL
National Provider Identifier
1124257712
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN 9267188 Issued in FL
Practice address
8175 NW 12TH St
Suite 306
Doral, FL 33126-1828
Phone
(786) 845-0173
Fax
(786) 845-0176
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 9267188 FL Primary

Addresses

Primary practice location

8175 NW 12TH St
Suite 306
Doral, FL 33126-1828

Mailing address

8175 NW 12TH St
Suite 306
Doral, FL 33126-1828
Phone (786) 845-0173

Other identifiers 1

IdentifierTypeStateIssuer
1720171895OtherFLMIAMI DADE COUNTY HEALTH DEPARTMENT - NPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 9267188FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health Past Accepting new patients
Florida Department of Health PastSince Feb 14, 2021 Accepting new patients

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": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1124257712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST",
            "address_2": "SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0173",
            "fax_number": "786-845-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 NW 12TH ST",
            "address_2": "SUITE 306",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331261828",
            "telephone_number": "786-845-0173",
            "fax_number": "786-845-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "MYRDENTZ",
        "credential": "R. N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 9267188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIAMI DADE COUNTY HEALTH DEPARTMENT - NPI NUMBER",
            "identifier": "1720171895",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.