Individual provider Active NPI

Lidia Tunyan, NP

  • Family Nurse Practitioner
  • Boca Raton, FL
National Provider Identifier
1336853779
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110238898 Issued in FL
Practice address
10472 Lake Vista Cir
Boca Raton, FL 33498-6742
Phone
(786) 440-1261
NPI assigned
Jan 10, 2023
Last updated
Jan 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 110238898 FL Primary

Addresses

Primary practice location

10472 Lake Vista Cir
Boca Raton, FL 33498-6742

Mailing address

10472 Lake Vista Cir
Boca Raton, FL 33498-6742
Phone (786) 440-1261

Other names 1

  • Lidia Tunyan Professional name

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
I20230726000876 FL Practitioner - Nurse Practitioner 3870953979 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110238898FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Surgical Specialists LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

4515 Wiles Rd
Ste 201
Coconut Creek, FL 33073
Phone (954) 943-1133

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1336853779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10472 LAKE VISTA CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986742",
            "telephone_number": "786-440-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10472 LAKE VISTA CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986742",
            "telephone_number": "786-440-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNYAN",
        "first_name": "LIDIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "110238898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIDIA",
            "last_name": "TUNYAN",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.