Individual provider Active NPI

Edvis Rodriguez Villalobos

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1295437390
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11025241 Issued in FL
Practice address
8345 Park Blvd Apt 6301
Miami, FL 33126-8058
Phone
(678) 886-5136
NPI assigned
Mar 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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 11025241 FL Primary

Addresses

Primary practice location

8345 Park Blvd Apt 6301
Miami, FL 33126-8058

Mailing address

8345 Park Blvd Apt 6301
Miami, FL 33126-8058
Phone (678) 886-5136

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
I20231109003467 FL Practitioner - Nurse Practitioner 9638526874 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11025241FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medtour 2 LLC CurrentSince Oct 23, 2023 Accepting new patients

Locations

10305 NW 41st St
Ste 203
Doral, FL 33178
Phone (786) 780-1180

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABHCDD/Endpoint/ABHCDD

Organizations & group practices 1

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1295437390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8345 PARK BLVD APT 6301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331268058",
            "telephone_number": "678-886-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8345 PARK BLVD APT 6301",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331268058",
            "telephone_number": "678-886-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VILLALOBOS",
        "first_name": "EDVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11025241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.