Individual provider Active NPI

Luis Avila

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1306448303
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11009266 Issued in FL
Practice address
1281 SW 144TH CT
Miami, FL 33184-3242
Phone
(305) 492-0885
NPI assigned
Nov 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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 11009266 FL Primary

Addresses

Primary practice location

1281 SW 144TH CT
Miami, FL 33184-3242

Mailing address

1281 SW 144TH CT
Miami, FL 33184-3242
Phone (305) 492-0885

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
I20240318002549 FL Practitioner - Nurse Practitioner 4486565272 Reassigns benefits to 1 organization

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
Genesis Wound Care Center LLCGroup PAC ID 7517358575, 11 clinicians

Practice addresses (Care Compare)

4995 NW 72ND Ave
Suite 406
Miami, FL 33166-5643
Phone (786) 290-6123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11009266FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Wound Care Center LLC CurrentSince Feb 11, 2024 Accepting new patients
All About Therapy and Rehabilitation Inc PastSince Aug 7, 2002 Accepting new patients

Locations

4995 NW 72nd Ave
Ste 406
Miami, FL 33166
Phone (305) 603-8410

Organizations & group practices 2

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": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1306448303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 SW 144TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331843242",
            "telephone_number": "305-492-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 SW 144TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331843242",
            "telephone_number": "305-492-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.