Individual provider Active NPI

Marien Marban Fernandez, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1164888285
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11004823 Issued in FL
Practice address
3762 SW 27TH LN
Miami, FL 33134-7222
Phone
(786) 237-6593
NPI assigned
Jan 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11004823 FL Primary

Addresses

Primary practice location

3762 SW 27TH LN
Miami, FL 33134-7222

Mailing address

3762 SW 27TH LN
Miami, FL 33134-7222
Phone (786) 237-6593

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
I20210125002492 FL Practitioner - Nurse Practitioner 2961816400

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lissette D Cortazar MdpaGroup PAC ID 7012240880, 3 clinicians

Practice addresses (Care Compare)

3659 S Miami Ave
Suite 5002
Miami, FL 33133-4231
Phone (305) 815-0055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11004823FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lissette D Cortazar Mdpa CurrentSince Nov 7, 2024 Accepting new patients
Syx, Corp. Case Management Past Accepting new patients

Locations

3661 S Miami Ave
Ste 402
Miami, FL 33133
Phone (305) 815-0055

3659 S Miami Ave
Ste 5002
Miami, FL 33133
Phone (305) 815-0055

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1164888285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 SW 27TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331347222",
            "telephone_number": "786-237-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3762 SW 27TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331347222",
            "telephone_number": "786-237-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBAN FERNANDEZ",
        "first_name": "MARIEN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11004823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.