Individual provider Active NPI

Roberto Cardoso, MSN, APRN, FPN-C

  • Family Nurse Practitioner
  • Miami Lakes, FL
National Provider Identifier
1285040907
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11005012 Issued in FL
Practice address
15105 NW 77TH Ave
Miami Lakes, FL 33014-7803
Phone
(305) 455-2737
NPI assigned
Jul 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11005012 FL
Family Nurse Practitioner 363LF0000X APRN11005012 FL Primary
Social Worker 104100000X

Addresses

Primary practice location

15105 NW 77TH Ave
Miami Lakes, FL 33014-7803

Mailing address

15105 NW 77TH Ave
Miami Lakes, FL 33014-7803
Phone (305) 455-2737

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcardoso1@email.suagm.edu Health Information Exchange (HIE)

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
I20221024000544 FL Practitioner - Nurse Practitioner 8527434109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Claremedica Viking LLCGroup PAC ID 4789112301, 75 clinicians

Practice addresses (Care Compare)

15105 NW 77 Ave
Miami Lakes, FL 33014-7803
Phone (305) 455-2737

27455 S Dixie Hwy
Unit 1
Homestead, FL 33032-8231
Phone (305) 245-3247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11005012FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Interamerican Medical Center Group LLC CurrentSince May 22, 2023 Accepting new patients
Interamerican Medical Center Group LLC Current Accepting new patients
Claremedica Viking LLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

27455 S Dixie Hwy
Unit 1
Homestead, FL 33032
Phone (305) 245-3247

1000 NW 57th Ct
Ste 400
Miami, FL 33126

15105 NW 77th Ave
Fl 4
Miami Lakes, FL 33014
Phone (305) 455-2737

15105 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 455-2737

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.

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1285040907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105 NW 77TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147803",
            "telephone_number": "305-455-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 NW 77TH AVE",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330147803",
            "telephone_number": "305-455-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOSO",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "MSN, APRN, FPN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11005012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005012",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcardoso1@email.suagm.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15634 SW 55th St",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331854149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.