Individual provider Active NPI

Nacin Fernandez, LCSW

  • Case Manager/Care Coordinator
  • South Miami, FL
National Provider Identifier
1306567144
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
5711 S Dixie Hwy
South Miami, FL 33143-3694
Phone
(786) 831-0687
NPI assigned
Sep 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X FL19623 FL
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

5711 S Dixie Hwy
South Miami, FL 33143-3694

Mailing address

5711 S Dixie Hwy
South Miami, FL 33143-3694
Phone (786) 831-0687

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217001505 FL Practitioner - Clinical Social Worker 1557737319 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FL19623FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
San Miguel Community Wellness Center CurrentSince Jan 30, 2023 Accepting new patients
Mtca Psychological Services P.a. CurrentSince Mar 1, 2023 Accepting new patients
Continuum Care of Miami Dade LLC PastSince Oct 9, 2022 Accepting new patients

Locations

19301 SW 87th Ave
Cutler Bay, FL 33157
Phone (305) 256-3500

7091 Atlantic Ave
Delray Beach, FL 33446
Phone (561) 558-2149

6067 Hollywood Blvd
Ste 200
Hollywood, FL 33024

12030 SW 129th Ct
Ste 206
Miami, FL 33186
Phone (305) 432-4032

16853 NE 2nd Ave
Ste S304
North Miami Beach, FL 33162

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1306567144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5711 S DIXIE HWY",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433694",
            "telephone_number": "786-831-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5711 S DIXIE HWY",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331433694",
            "telephone_number": "786-831-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "NACIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "FL19623",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

Verify at the official NPI Registry.