Individual provider Active NPI

Amina Marie Defalco, APRN

  • Family Nurse Practitioner
  • Fort Pierce, FL
National Provider Identifier
1376388215
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11033594 Issued in FL
Practice address
1300 N Lawnwood Cir
Fort Pierce, FL 34950-4884
Phone
(772) 302-3977
Fax
(877) 229-5205
NPI assigned
Jul 1, 2024
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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 11033594 FL Primary

Addresses

Primary practice location

1300 N Lawnwood Cir
Fort Pierce, FL 34950-4884

Mailing address

915 SW Butterfly Ter
Port St Lucie, FL 34953-1526
Phone (772) 342-2715

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
I20260428003069 FL Practitioner - Nurse Practitioner 1658848536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1897 Grey Falcon Cir SW
Vero Beach, FL 32962-8611

1900 Nebraska Ave
Suite 9
Fort Pierce, FL 34950-4837

2535 NE 193Rd St
Miami, FL 33180-3477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11033594FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anley Cardiovascular PLLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1300 N Lawnwood Cir
Fort Pierce, FL 34950
Phone (305) 788-4440

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1376388215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 SW BUTTERFLY TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531526",
            "telephone_number": "772-342-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N LAWNWOOD CIR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504884",
            "telephone_number": "772-302-3977",
            "fax_number": "877-229-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFALCO",
        "first_name": "AMINA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.