Individual provider Active NPI

Sandra Diaz, ARNP, FNP-BC

  • Family Nurse Practitioner
  • Plantation, FL
National Provider Identifier
1396135844
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014012312 Issued in FL
Practice address
8320 W Sunrise Blvd Ste 205
Plantation, FL 33322-5432
Phone
(800) 640-3451
Fax
(561) 367-8257
NPI assigned
Feb 4, 2015
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 2014012312 FL Primary

Addresses

Primary practice location

8320 W Sunrise Blvd Ste 205
Plantation, FL 33322-5432

Mailing address

439 S Pleasant Grove Blvd Ste 3
Pleasant Grove, UT 84062-3493
Phone (800) 640-3451

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
I20180122002738 FL Practitioner - Nurse Practitioner 9234498189 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

8320 W Sunrise Blvd
Suite 208
Plantation, FL 33322-5432
Phone (800) 640-3451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014012312FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer J Hardenbrook MD PC CurrentSince May 1, 2024 Accepting new patients
Integrated Medical Direction CurrentSince Sep 1, 2017 Accepting new patients
On-Site Wound Consultants P.a CurrentSince Sep 1, 2017 Accepting new patients
Wound Technology Network Inc CurrentSince Mar 3, 2020 Accepting new patients

Locations

5979 Vineland Rd
Ste 109
Orlando, FL 32819
Phone (407) 270-7702

8320 W Sunrise Blvd
Ste 208
Plantation, FL 33322
Phone (904) 203-8853

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EICJAD

Organizations & group practices 4

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": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1396135844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 S PLEASANT GROVE BLVD STE 3",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623493",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 W SUNRISE BLVD STE 205",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225432",
            "telephone_number": "800-640-3451",
            "fax_number": "561-367-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "SANDRA",
        "credential": "ARNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2014012312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.