Individual provider Active NPI

Jose Marino-Morales, APRN

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1164147393
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11022448 Issued in FL
Practice address
5615 S Florida Ave Ste 111
Lakeland, FL 33813-2714
Phone
(863) 327-0132
NPI assigned
Oct 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11022448 FL
Family Nurse Practitioner 363LF0000X APRN11022448 FL Primary

Addresses

Primary practice location

5615 S Florida Ave Ste 111
Lakeland, FL 33813-2714

Mailing address

6100 Blue Lagoon Dr Ste 365
Miami, FL 33126-7010
Phone (786) 322-7333

Other practice location 1

1415 S Collins St
Plant City, FL 33563-6577
Phone (813) 906-1411

Other identifiers 1

IdentifierTypeStateIssuer
117341800MedicaidFL

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
I20250321002761 FL Practitioner - Nurse Practitioner 7810419561 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11022448FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Group of Tampa, LLC. CurrentSince Mar 1, 2023 Accepting new patients
Access Medical Group of Lakeland, LLC CurrentSince Jan 24, 2025 Accepting new patients

Locations

5615 S Florida Ave
Ste 111
Lakeland, FL 33813
Phone (863) 327-0132

6100 Blue Lagoon Dr
Ste 365
Miami, FL 33126
Phone (786) 322-7333

1415 S Collins St
Plant City, FL 33563
Phone (813) 906-1411

Interoperability endpoints

  • Direct secure messaging: jose.marinomorales.p1@direct.bondclinicpa.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1164147393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 BLUE LAGOON DR STE 365",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331267010",
            "telephone_number": "786-322-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 S FLORIDA AVE STE 111",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132714",
            "telephone_number": "863-327-0132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 S Collins St",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335636577",
            "country_code": "US",
            "telephone_number": "813-906-1411",
            "fax_number": "813-413-1966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINO-MORALES",
        "first_name": "JOSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11022448",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11022448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117341800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.