Individual provider Active NPI

Judy Ann Alonso-Slusarz

  • Family Nurse Practitioner
  • Maitland, FL
National Provider Identifier
1194297291
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9172348 Issued in FL
Practice address
2600 Lake Lucien Dr Ste 112
Maitland, FL 32751-7233
Phone
(321) 207-9029
Fax
(844) 410-7960
NPI assigned
Dec 30, 2018
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9172348 FL
Family Nurse Practitioner 363LF0000X APRN9172348 FL Primary

Addresses

Primary practice location

2600 Lake Lucien Dr Ste 112
Maitland, FL 32751-7233

Mailing address

500 Kirts Blvd Ste 100
Troy, MI 48084-4135
Phone (248) 434-6169

Other practice location 1

1130 ODay Dr
Winter Springs, FL 32708-6204
Phone (407) 310-5935 ext. 40731

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
I20190124001195 FL Practitioner - Nurse Practitioner 5991042285 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9172348FLMDFamily Medicine Physician
APRN9172348FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Healthcare PA CurrentSince Feb 21, 2022 Accepting new patients
Rmed LLC Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Rmed LLC Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Iah of Florida, LLC Family Medicine CurrentSince Jul 22, 2022 Accepting new patients
Marion Internal Medicine Associates CurrentSince Mar 21, 2022 Accepting new patients

Locations

4348 Southpoint Blvd
Ste 100
Jacksonville, FL 32216
Phone (904) 281-1087

2600 Lake Lucien Dr
Ste 112
Maitland, FL 32751
Phone (321) 207-9029

1805 SE Lake Weir Ave
Ste B
Ocala, FL 34471
Phone (352) 629-9634

8600 Hidden River Pkwy
Ste 75
Tampa, FL 33637
Phone (813) 517-0137

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

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, 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": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1194297291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-434-6169",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR STE 112",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517233",
            "telephone_number": "321-207-9029",
            "fax_number": "844-410-7960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 ODay Dr",
            "address_purpose": "LOCATION",
            "city": "Winter Springs",
            "state": "FL",
            "postal_code": "327086204",
            "country_code": "US",
            "telephone_number": "407-310-5935 x40731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALONSO-SLUSARZ",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-30",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "9172348",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9172348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.