NPIMap

Individual provider Active NPI

Maikel Guerra Diaz

  • Primary Care Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1134716038
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
11010778 Issued in FL
Practice address
182 E 49TH St
Hialeah, FL 33013-1853
Phone
(786) 484-4096
NPI assigned
Dec 26, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 11010778 FL Primary

Addresses

Primary practice location

182 E 49TH St
Hialeah, FL 33013-1853

Mailing address

11455 W Flagler St Apt 604
Miami, FL 33174-4016
Phone (786) 484-4096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006000236 FL Practitioner - Nurse Practitioner 0547668568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enzo L Abad DO PLGroup PAC ID 6002942109, 2 clinicians

Practice addresses (Care Compare)

182 E 49 St
Hialeah, FL 33013-1853
Phone (305) 512-4460

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022
  • Hialeah Hospital Hospital, Hialeah, FL, CCN 100053
  • Larkin Community Hospital Palm Springs Campus Hospital, Hialeah, FL, CCN 100050
  • Palmetto General Hospital Hospital, Hialeah, FL, CCN 100187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010778FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Enzo L Abad DO PL CurrentSince Jul 1, 2021 Accepting new patients

Locations

182 E 49th St
Hialeah, FL 33013
Phone (305) 512-4460

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

Interoperability endpoints

  • Direct secure messaging: maikel.guerradiaz.p1@direct.caremax.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1134716038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11455 W FLAGLER ST APT 604",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331744016",
            "telephone_number": "786-484-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 E 49TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330131853",
            "telephone_number": "786-484-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA DIAZ",
        "first_name": "MAIKEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-26",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11010778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.