Individual provider Active NPI

Katelyn Michelle Mirante

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Fort Lauderdale, FL
National Provider Identifier
1306580832
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
APRN11018534 Issued in FL
Practice address
2425 E Commercial Blvd Ste 405
Fort Lauderdale, FL 33308-4029
Phone
(855) 284-7483
Fax
(617) 807-0958
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X APRN11018534 FL Primary

Addresses

Primary practice location

2425 E Commercial Blvd Ste 405
Fort Lauderdale, FL 33308-4029

Mailing address

1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724
Phone (855) 284-7483

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
I20220830000298 FL Practitioner - Nurse Practitioner 5890177588 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
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

2425 E Commercial Blvd
Suite 405
Fort Lauderdale, FL 33308-4029
Phone (754) 400-5514

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc CurrentSince Jun 16, 2022 Accepting new patients

Locations

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

4115 W Spruce St
Ste 205
Tampa, FL 33607
Phone (813) 413-4663

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1306580832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JEFFERSON ST STE 2C",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041724",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E COMMERCIAL BLVD STE 405",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084029",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANTE",
        "first_name": "KATELYN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11018534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.