Individual provider Active NPI

Hailys Lezcano Vento

  • Family Nurse Practitioner
  • Hallandale Beach, FL
National Provider Identifier
1265037691
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11008529 Issued in FL
Practice address
1460 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4617
Phone
(305) 266-2929
Fax
(305) 504-8868
NPI assigned
Dec 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11008529 GA
Family Nurse Practitioner 363LF0000X 11008529 FL Primary

Addresses

Primary practice location

1460 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4617

Mailing address

9200 Bay Harbor Ter Apt 3a
Bay Harbor Islands, FL 33154-2733
Phone (305) 790-3082

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
I20210120001555 FL Practitioner - Nurse Practitioner 4082028782 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11008529FLMDFamily Nurse Practitioner
11008529GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Lopez de Mendoza, MD PLLC CurrentSince Jan 1, 2021 Accepting new patients
Medcare Centers, LLC CurrentSince Apr 18, 2024 Accepting new patients
Medcare Centers, LLC CurrentSince Apr 18, 2024 Accepting new patients
Centrum Medical Holdings, LLC Current Accepting new patients
Med Care Centers LLC Current Accepting new patients
Centrum Medical Centers Kendall, LLC CurrentSince Jul 28, 2021 Accepting new patients
Centrum Medical Holdings, LLC CurrentSince Jul 28, 2021 Accepting new patients

Locations

9250 NW 36th St
Ste 420
Doral, FL 33178
Phone (786) 873-1805

1460 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 455-2385

3661 S Miami Ave
Ste 901
Miami, FL 33133
Phone (305) 856-5057

7200 NW 7th St
Ste 150
Miami, FL 33126
Phone (305) 264-6270

5730 SW 74th St
Ste 200
South Miami, FL 33143

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1265037691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 BAY HARBOR TER APT 3A",
            "city": "BAY HARBOR ISLANDS",
            "state": "FL",
            "postal_code": "331542733",
            "telephone_number": "305-790-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094617",
            "telephone_number": "305-266-2929",
            "fax_number": "305-504-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEZCANO VENTO",
        "first_name": "HAILYS",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "11008529",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11008529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.