Individual provider Active NPI

Cristian Jossue Guzman-Berrios, FNP-C

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1346940848
Registry record updated Mar 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11025109 Issued in FL
Practice address
171 Mexicali Ave
Kissimmee, FL 34743-9515
Phone
(407) 627-7449
NPI assigned
Mar 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03230099 FL
Family Nurse Practitioner 363LF0000X 11025109 FL Primary

Addresses

Primary practice location

171 Mexicali Ave
Kissimmee, FL 34743-9515

Mailing address

171 Mexicali Ave
Kissimmee, FL 34743-9515
Phone (407) 627-7449

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
I20240405003823 FL Practitioner - Nurse Practitioner 3870931033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11025109FLMDFamily Nurse Practitioner
F03230099FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Central Florida LLP CurrentSince Feb 13, 2024 Accepting new patients

Locations

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

92 W Miller St
Orlando, FL 32806
Phone (321) 841-4607

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678579200000",
    "number": "1346940848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MEXICALI AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439515",
            "telephone_number": "407-627-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MEXICALI AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347439515",
            "telephone_number": "407-627-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN-BERRIOS",
        "first_name": "CRISTIAN",
        "middle_name": "JOSSUE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-12",
        "certification_date": "2023-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F03230099",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11025109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.