Individual provider Active NPI

Esdras Guillaume, APRN

  • Family Nurse Practitioner
  • North Miami, FL
National Provider Identifier
1124564620
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11037095 Issued in FL
Practice address
14311 Biscayne Blvd Unit 610861
North Miami, FL 33261-3099
Phone
(954) 394-7060
NPI assigned
Jan 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X FL
Family Nurse Practitioner 363LF0000X APRN11037095 FL Primary

Addresses

Primary practice location

14311 Biscayne Blvd Unit 610861
North Miami, FL 33261-3099

Mailing address

14331 Biscayne Blvd Ste 610861
North Miami, FL 33261-3000
Phone (954) 394-7060

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11037095FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1124564620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14331 BISCAYNE BLVD STE 610861",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "332613000",
            "telephone_number": "954-394-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14311 BISCAYNE BLVD UNIT 610861",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "332613099",
            "telephone_number": "954-394-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLAUME",
        "first_name": "ESDRAS",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11037095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.