Individual provider Active NPI

Antonina Eremenko, NP-C

  • Family Nurse Practitioner
  • Miami Beach, FL
National Provider Identifier
1316567753
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003858 Issued in FL
Practice address
1370 Washington Ave Ste 224
Miami Beach, FL 33139-4215
Phone
(786) 673-4029
NPI assigned
Apr 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 11003858 FL Primary

Addresses

Primary practice location

1370 Washington Ave Ste 224
Miami Beach, FL 33139-4215

Mailing address

1370 Washington Ave Ste 224
Miami Beach, FL 33139-4215
Phone (786) 673-4029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11003858FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evivia CurrentSince May 1, 2020 Accepting new patients

Locations

66 W Flagler St
Unit 900
Miami, FL 33130
Phone (786) 530-3128

1370 Washington Ave
Ste 224
Miami Beach, FL 33139
Phone (786) 673-4029

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1316567753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 WASHINGTON AVE STE 224",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331394215",
            "telephone_number": "786-673-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 WASHINGTON AVE STE 224",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331394215",
            "telephone_number": "786-673-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EREMENKO",
        "first_name": "ANTONINA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.