Individual provider Active NPI

Suzelle Portogues, LPN

  • Licensed Practical Nurse
  • Homestead, FL
National Provider Identifier
1124430061
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5196469 Issued in FL
Practice address
650 N Homestead Blvd
Homestead, FL 33030-6210
Phone
(786) 243-5900
Fax
(786) 243-5935
NPI assigned
May 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5196469 FL Primary

Addresses

Primary practice location

650 N Homestead Blvd
Homestead, FL 33030-6210

Mailing address

650 N Homestead Blvd
Homestead, FL 33030-6210
Phone (786) 243-5900

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

State licenses

LicenseStateTypeSpecialty
PN5196469FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1124430061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330306210",
            "telephone_number": "786-243-5900",
            "fax_number": "786-243-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N HOMESTEAD BLVD",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330306210",
            "telephone_number": "786-243-5900",
            "fax_number": "786-243-5935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTOGUES",
        "first_name": "SUZELLE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5196469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.