Individual provider Active NPI

Brandon Nieves Stella

  • Other Technician
  • Fort Lauderdale, FL
National Provider Identifier
1164975934
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
620 SW 14TH Ter
Fort Lauderdale, FL 33312
Phone
(561) 929-4245
NPI assigned
Jul 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

620 SW 14TH Ter
Fort Lauderdale, FL 33312

Mailing address

620 SW 14TH Ter
Fort Lauderdale, FL 33312
Phone (561) 929-4245

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

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1164975934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SW 14TH TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33312",
            "telephone_number": "561-929-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SW 14TH TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33312",
            "telephone_number": "561-929-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES STELLA",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.