Fidel Alejandro Pupo Perez, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11023465 Issued in FL

Practice address

510 NW 29TH Ter
Fort Lauderdale, FL 33311-7638

Phone

(502) 403-4627

NPI assigned

Oct 4, 2023

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Radial Health Southeast LLC

  • Physical Medicine & Rehabilitation Physician
  • Navarre, FL
  • NPI 1174159891
  Medicare reassignment NPD

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1265212336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NW 29TH TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333117638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NW 29TH TER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333117638",
            "telephone_number": "502-403-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUPO PEREZ",
        "first_name": "FIDEL",
        "middle_name": "ALEJANDRO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11023465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mabel Pulido
• Moon M Pulido, PHARM.D., RPH
• Donald Ross Puller, MD
• Pulmonary and Critical Care Consultants Inc
• Edward Punzalan, CRNA
• Courtney Kristen Purdy, PSY.D.
• Pure Affection Home Health LLC
• Pure Care USA LLC
• Pure Wellness Behavioral Counseling
• Alvin Puri, PT, DPT

• Family Nurse Practitioner in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.