Individual provider Active NPI

Karen Puello, APRN

  • Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1285201079
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11012804 Issued in FL
Practice address
1951 SW 172ND Ave Ste 408
Miramar, FL 33029-5614
Phone
(954) 538-5470
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11012804 FL Primary

Addresses

Primary practice location

1951 SW 172ND Ave Ste 408
Miramar, FL 33029-5614

Mailing address

7226 NW 42ND St
Coral Springs, FL 33065-2109
Phone (954) 815-2466

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
I20220331001305 FL Practitioner - Nurse Practitioner 5799171757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

Hospital & facility affiliations

  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Dec 25, 2021 Accepting new patients
South Broward Hospital District CurrentSince Dec 25, 2021 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

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

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

1951 SW 172nd Ave
Ste 408
Miramar, FL 33029
Phone (305) 606-7028

1951 SW 172nd Ave
Ste 204
Miramar, FL 33029
Phone (954) 967-9400

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

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 1

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": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1285201079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7226 NW 42ND ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652109",
            "telephone_number": "954-815-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE STE 408",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295614",
            "telephone_number": "954-538-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUELLO",
        "first_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11012804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.