Individual provider Active NPI

Queena Surles, APRN

  • Primary Care Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1134926199
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11037787 Issued in FL
Practice address
17634 SW 6TH St
Pembroke Pines, FL 33029-4023
Phone
(954) 616-7846
NPI assigned
Feb 27, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 APRN11037787 FL Primary

Addresses

Primary practice location

17634 SW 6TH St
Pembroke Pines, FL 33029-4023

Mailing address

17634 SW 6TH St
Pembroke Pines, FL 33029-4023

Other names 1

  • Queena Simmons Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11037787FLMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1134926199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17634 SW 6TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17634 SW 6TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294023",
            "telephone_number": "954-616-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURLES",
        "first_name": "QUEENA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11037787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QUEENA",
            "last_name": "SIMMONS",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.