Jacqueline Hurtado, MSN, RN, CPNP, CCRN

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

11027177 Issued in FL

Practice address

1611 NW 12TH Ave
Miami, FL 33136-1005

Phone

(305) 585-5437

NPI assigned

Nov 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Public Health Trust of Miami Dade County Florida

  dba JMG Specialty Physicians

  • General Practice Physician
  • Miami, FL
  • NPI 1134384423
  Medicare reassignment NPD
• Public Health Trust of Dade County Florida

  • Pediatric Cardiology Physician
  • Miami, FL
  • NPI 1952056111
  NPD
• Public Health Trust of Dade County Florida

  dba JMG Specialty Physicians

  • Family Medicine Physician
  • Miami, FL
  • NPI 1902978695
  NPD (past)

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1174127765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N OLIVE AVE APT 226",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013733",
            "telephone_number": "714-765-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-660-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURTADO",
        "first_name": "JACQUELINE",
        "name_prefix": "Miss",
        "credential": "MSN, RN, CPNP, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "FL",
            "license": "11027177",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "CA",
            "license": "95013955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iliana Samara Hurtado Rendon, MD
• Michelle A Hurtado Shan
• Idania Hurtado-Perez, M.D.
• Cesar F Hurtado Jr., DDS
• Gabriela Hurtado
• Judith Hurtado, INSURANCE AGENT
• Lina Hurtado, M.D.
• Macie Wilkins Hurtado, MD
• Myrtha Rosa Hurtado
• Natalia Hurtado

• Critical Care Pediatric Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Critical Care Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.