Marielys Cantillo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11024556 Issued in FL

Practice address

1479 NW 27TH Ave
Miami, FL 33125-2133

Phone

(305) 633-3776

Fax

(305) 633-3776

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sji Medical PAGroup PAC ID 8729325600, 4 clinicians

PL Roberts Id LLCGroup PAC ID 1658818299, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• PL Roberts Id LLC

  • Infectious Disease Physician
  • Hialeah, FL
  • NPI 1700622412
  Medicare reassignment Care Compare group NPD
• Sji Medical, P.a.

  • Infectious Disease Physician
  • Pembroke Pines, FL
  • NPI 1366932527
  Medicare reassignment Care Compare group NPD
• Clinica Las Mercedes, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Miami, FL
  • NPI 1326090960
  Medicare reassignment NPD
• Clinica Las Mercedes, LLC

  • Multi-Specialty Clinic/Center
  • Tamarac, FL
  • NPI 1518673565
  NPD

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1124722095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 NW 27TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252133",
            "telephone_number": "305-633-3776",
            "fax_number": "305-633-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 NW 27TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252133",
            "telephone_number": "305-633-3776",
            "fax_number": "305-633-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTILLO",
        "first_name": "MARIELYS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11024556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Cantiello, PHARMD
• Daylet Margarita Cantillo Concepcion
• Manuel A Cantillo Perez
• Joanna Cantillo
• Leslie Chanel Cantillo
• Randall Cantillo, ACUPUNCTURIST
• Anselmo Canto Quintana
• Ada C Canto, PT
• David Edward Canto, AGACNP-BC
• Dianez Canto, APRN

• Family Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.