Individual provider Active NPI

Carol Nancy Zamora, FNP-BC

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1265770002
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9182474 Issued in FL
Practice address
4651 Sheridan St Ste 350
Hollywood, FL 33021-3425
Phone
(954) 276-8559
Fax
(954) 966-9762
NPI assigned
Jan 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 9182474 FL Primary

Addresses

Primary practice location

4651 Sheridan St Ste 350
Hollywood, FL 33021-3425

Mailing address

2900 Corporate Way Ste D
Miramar, FL 33025-3925
Phone (954) 276-5603

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address czamora182387@MHSDIRECT.NET Direct

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
I20160104000192 FL Practitioner - Nurse Practitioner 9739481102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

20801 Biscayne Blvd
Suite 203
Aventura, FL 33180-1492
Phone (954) 265-0072

2301 N University Dr
Pembroke Pines, FL 33024-3617
Phone (954) 267-1400

4651 Sheridan St
Suite 350
Hollywood, FL 33021-3425
Phone (954) 276-8559

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9182474FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Jun 25, 2020 Accepting new patients
South Broward Hospital District CurrentSince Jun 25, 2020 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

20801 Biscayne Blvd
Ste 203
Aventura, FL 33180
Phone (305) 682-2580

4651 Sheridan St
Ste 350
Hollywood, FL 33021
Phone (954) 276-8559

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Interoperability endpoints

  • Direct secure messaging: czamora182387@mhsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1265770002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY STE D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SHERIDAN ST STE 350",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213425",
            "telephone_number": "954-276-8559",
            "fax_number": "954-966-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "CAROL",
        "middle_name": "NANCY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9182474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "czamora182387@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4651 Sheridan St Ste 350",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330213425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.