Ileana Petisco, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

RN9310298 Issued in FL

Practice address

13370 SW 131St St Ste 107
Miami, FL 33186-5856

Phone

(786) 713-0954

Fax

(786) 713-0958

NPI assigned

Jul 9, 2026

Last updated

Jul 9, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Living Waters Healthcare Services LLC

  • Home Health Agency
  • Miami, FL
  • NPI 1861298242
  NPD (past) Authorized official

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

{
    "created_epoch": "1783555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1225956881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13370 SW 131ST ST STE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865856",
            "telephone_number": "786-713-0954",
            "fax_number": "786-713-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13370 SW 131ST ST STE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331865856",
            "telephone_number": "786-713-0954",
            "fax_number": "786-713-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETISCO",
        "first_name": "ILEANA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "RN9310298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Judith Peterson, B.S.W
• Catherine D Peterson, LCSW
• Christopher Scott Peterson, DPM
• Eric Cecala Peterson, MD
• Leslie A Peterson, PHARMACIST
• Petit LLC
• Daphne Petit-Homme, MD
• Christine Petit-Jean, LCSW
• Francoise Petit
• Erline Petitfrere Estiven

• Home Health Registered Nurse in Miami, FL
• Providers in Miami, FL by specialty
• Home Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.