Individual provider Active NPI

Nancy Vazquez, FNP-C

  • Family Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1306403373
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001923 Issued in FL
Practice address
1055 Saxon Blvd
Orange City, FL 32763-8468
Phone
(386) 917-5107
NPI assigned
May 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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 11001923 FL Primary

Addresses

Primary practice location

1055 Saxon Blvd
Orange City, FL 32763-8468

Mailing address

298 S Yonge St
Ormond Beach, FL 32174-6264
Phone (386) 274-7800

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
I20190624002269 FL Practitioner - Nurse Practitioner 6305170408 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001923FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Professionals PA CurrentSince Jun 1, 2019 Accepting new patients

Locations

701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

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": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1306403373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 S YONGE ST",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746264",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-917-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "NANCY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.