Individual provider Active NPI

Kimberly Nicole Amigo, APRN

  • Adult Health Nurse Practitioner
  • Aventura, FL
National Provider Identifier
1124669635
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11004309 Issued in FL
Practice address
20801 Biscayne Blvd Ste 201
Aventura, FL 33180-1422
Phone
(305) 682-2670
Fax
(305) 792-5232
NPI assigned
Oct 6, 2019
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11004309 FL Primary

Addresses

Primary practice location

20801 Biscayne Blvd Ste 201
Aventura, FL 33180-1422

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klakey224359@MHSDIRECT.NET Direct

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
I20191127001471 FL Practitioner - Nurse Practitioner 2769815000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1150 N 35TH Ave
Suite 590
Hollywood, FL 33021-5468
Phone (954) 265-9500

20801 Biscayne Blvd
Suite 200
Aventura, FL 33180-1422
Phone (954) 682-2900

4302 Alton Rd
Suite 330
Miami Beach, FL 33140-2818
Phone (305) 532-2464

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11004309FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Nov 1, 2019 Accepting new patients
South Broward Hospital District CurrentSince Nov 1, 2019 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20801 Biscayne Blvd
Ste 200
Aventura, FL 33180
Phone (954) 265-3015

20801 Biscayne Blvd
Ste 201
Aventura, FL 33180
Phone (305) 682-2670

1150 N 35th Ave
Ste 590
Hollywood, FL 33021
Phone (954) 265-9500

2063 Biscayne Blvd
Ste 501
Miami, FL 33137
Phone (954) 265-7700

4302 Alton Rd
Ste 330
Miami Beach, FL 33140
Phone (305) 532-2464

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5663

601 N Flamingo Rd
Ste 204
Pembroke Pines, FL 33028
Phone (954) 276-1474

Interoperability endpoints

  • Direct secure messaging: klakey224359@mhsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1124669635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20801 BISCAYNE BLVD STE 201",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801422",
            "telephone_number": "305-682-2670",
            "fax_number": "305-792-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIGO",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-06",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11004309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klakey224359@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "20801 Biscayne Blvd Ste 201",
            "city": "Aventura",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331801422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.