Individual provider Active NPI

Jorge Luis Ulloa Capestany, APRN

  • Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1356942031
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11010052 Issued in FL
Practice address
6865 W 7TH Ave Apt 408
Hialeah, FL 33014-4877
Phone
(786) 307-2572
NPI assigned
Nov 8, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11010052 FL Primary

Addresses

Primary practice location

6865 W 7TH Ave Apt 408
Hialeah, FL 33014-4877

Mailing address

6865 W 7TH Ave Apt 408
Hialeah, FL 33014-4877
Phone (786) 307-2572

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
I20210910002838 FL Practitioner - Nurse Practitioner 1557767803 Practice locations: Hialeah, FL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11010052FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1356942031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6865 W 7TH AVE APT 408",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330144877",
            "telephone_number": "786-307-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 W 7TH AVE APT 408",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330144877",
            "telephone_number": "786-307-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLOA CAPESTANY",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11010052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.