Prestige Integrated Healthcare Solutions LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PRESTIGE INTEGRATED HEALTHCARE SOLUTIONS LLC

Practice address

9623 SE 110TH Street Rd
Belleview, FL 34420-3661

Phone

(352) 605-2520

Fax

(813) 755-3366

NPI assigned

Sep 17, 2025

Organization subpart

No

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

Authorized official

Name

Derek BrunerNPI 1376228528

Title

Practice Owner

Phone

(352) 239-5958

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Allen Roscoe, FNP-BC

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1518645969
  Medicare reassignment NPD
• Derek Wayne Bruner, FNP-BC

  • Family Nurse Practitioner
  • Gainesville, FL
  • NPI 1376228528
  NPD Authorized official

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1124999453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344210161",
            "telephone_number": "352-605-2520",
            "fax_number": "813-755-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9623 SE 110TH STREET RD",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203661",
            "telephone_number": "352-605-2520",
            "fax_number": "813-755-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE INTEGRATED HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "BRUNER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "352-239-5958"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pishotta, DC
• Molly Ann Poucher, APRN
• Julynnet Powell, RDN, LDN
• Claudia Jean Pratt
• Prestige 786 LLC
• Prestige Manor Business LLC
• Prestige Manor Business LLC
• Prestige Manor LLC
• Prestige Manor LLC
• Publix Super Markets, Inc.

• Nurse Practitioner in Belleview, FL
• Providers in Belleview, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.