Individual provider Active NPI

Soja Juby, APRN

  • Adult Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1184243065
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11004114 Issued in FL
Practice address
19380 SW 14TH St
Pembroke Pines, FL 33029-6121
Phone
(954) 990-3287
NPI assigned
Apr 10, 2020
Last updated
Jun 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN11004114 FL Primary

Addresses

Primary practice location

19380 SW 14TH St
Pembroke Pines, FL 33029-6121

Mailing address

19380 SW 14TH St
Pembroke Pines, FL 33029-6121
Phone (954) 990-3287

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
I20210202001111 FL Practitioner - Nurse Practitioner 6103230222 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aslam M Khan MD PA CurrentSince Jan 1, 2021 Accepting new patients

Locations

4900 W Oakland Park Blvd
Ste 207
Lauderdale Lakes, FL 33313
Phone (954) 735-7550

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1184243065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19380 SW 14TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330296121",
            "telephone_number": "954-990-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19380 SW 14TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330296121",
            "telephone_number": "954-990-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUBY",
        "first_name": "SOJA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11004114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.