Individual provider Active NPI

Haley Puk

  • Psychiatric/Mental Health Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1376377911
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11034959 Issued in FL
Practice address
5915 Ponce de Leon Blvd Ste 26
Coral Gables, FL 33146-2435
Phone
(786) 664-7810
NPI assigned
Aug 27, 2024
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 Nurse Practitioner 363LP0808X 11034959 FL Primary

Addresses

Primary practice location

5915 Ponce de Leon Blvd Ste 26
Coral Gables, FL 33146-2435

Mailing address

470 NE 5TH Ave Apt 3427
Fort Lauderdale, FL 33301-2502
Phone (319) 493-0200

Other practice location 1

470 NE 5th Ave Apt 3427
Fort Lauderdale, FL 33301-2502
Phone (319) 493-0200

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
I20251218000760 FL Practitioner - Nurse Practitioner 9739674615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida International Univ, College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Raul J Rodriguez MdpaGroup PAC ID 0042477564, 20 clinicians

Practice addresses (Care Compare)

403 SE 1St St
Delray Beach, FL 33483-4540
Phone (561) 266-8866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11034959FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Raul J Rodriguez Mdpa CurrentSince Dec 1, 2025 Accepting new patients
Sfim II, LLC PastSince Oct 20, 2024 Accepting new patients
South Florida Integrative Medicine PastSince Oct 20, 2024 Accepting new patients

Locations

403 SE 1st St
Delray Beach, FL 33483
Phone (561) 266-8866

Organizations & group practices 3

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": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1376377911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 NE 5TH AVE APT 3427",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012502",
            "telephone_number": "319-493-0200",
            "fax_number": "305-340-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 PONCE DE LEON BLVD STE 26",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462435",
            "telephone_number": "786-664-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 NE 5th Ave Apt 3427",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333012502",
            "country_code": "US",
            "telephone_number": "319-493-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUK",
        "first_name": "HALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11034959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.