Individual provider Active NPI

Lucadet Raphael Vedrine

  • Acute Care Nurse Practitioner
  • Miami, FL
National Provider Identifier
1174166102
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11004754 Issued in FL
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(305) 585-6970
NPI assigned
Oct 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11004754 FL Primary

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

PO Box 100108
Gainesville, FL 32610-0108
Phone (352) 273-5670

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
I20200326003720 FL Practitioner - Nurse Practitioner 1153750120 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Mar 23, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Mar 23, 2020 Accepting new patients
University of Miami CurrentSince Jan 11, 2022 Accepting new patients
University of Miami CurrentSince Jan 11, 2022 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1400 NW 12th Ave
Miami, FL 33136
Phone (305) 325-5416

Organizations & group practices 5

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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1174166102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100108",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100108",
            "telephone_number": "352-273-5670",
            "fax_number": "352-273-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-585-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDRINE",
        "first_name": "LUCADET",
        "middle_name": "RAPHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11004754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.