Individual provider Active NPI

Stephanie Rocio Carvajal Jimenez, APRN

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1174485684
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11043963 Issued in FL
Practice address
300 N 70TH Way
Hollywood, FL 33024-7316
Phone
(954) 544-1193
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11043963 FL Primary

Addresses

Primary practice location

300 N 70TH Way
Hollywood, FL 33024-7316

Mailing address

300 N 70TH Way
Hollywood, FL 33024-7316
Phone (954) 544-1193

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

State licenses

LicenseStateTypeSpecialty
APRN11043963FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1174485684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 70TH WAY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247316",
            "telephone_number": "954-544-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 70TH WAY",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247316",
            "telephone_number": "954-544-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL JIMENEZ",
        "first_name": "STEPHANIE",
        "middle_name": "ROCIO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11043963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.