Individual provider Active NPI

Dagoberto Bueno Martin

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1205604592
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11030833 Issued in FL
Practice address
175 SW 7TH St Ste 1207
Miami, FL 33130-2952
Phone
(786) 681-6811
NPI assigned
Dec 15, 2023
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11030833 FL Primary

Addresses

Primary practice location

175 SW 7TH St Ste 1207
Miami, FL 33130-2952

Mailing address

301 SW 30TH CT
Miami, FL 33135-2718
Phone (305) 780-3545

Other practice location 1

3003 S Congress Ave Ste 2B
Palm Springs, FL 33461-2169
Phone (561) 785-5811

Other practice location 2

12595 SW 137th Ave Ste 103
Miami, FL 33186-4218
Phone (786) 649-8420

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
APRN11030833FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1205604592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SW 30TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352718",
            "telephone_number": "305-780-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SW 7TH ST STE 1207",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331302952",
            "telephone_number": "786-681-6811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 S Congress Ave Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "FL",
            "postal_code": "334612169",
            "country_code": "US",
            "telephone_number": "561-785-5811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12595 SW 137th Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331864218",
            "country_code": "US",
            "telephone_number": "786-649-8420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUENO MARTIN",
        "first_name": "DAGOBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11030833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.