Active NPI
Idalmis Barbara Pena Licea, ARNP-FNP
- Family Medicine Physician
- Hialeah, FL
National Provider Identifier
1396522710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F07231304
- Practice address
- 501 W 68TH St Apt 2
Hialeah, FL 33014-4900 - Phone
- (305) 213-3692
- NPI assigned
- Sep 11, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F07231304 | FL | Primary |
Addresses
Primary practice location
501 W 68TH St Apt 2
Hialeah, FL 33014-4900
Mailing address
501 W 68TH St Apt 2
Hialeah, FL 33014-4900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F07231304 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1396522710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 W 68TH ST APT 2",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330144900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W 68TH ST APT 2",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330144900",
"telephone_number": "305-213-3692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA LICEA",
"first_name": "IDALMIS",
"middle_name": "BARBARA",
"credential": "ARNP-FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2023-09-11",
"certification_date": "2023-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "F07231304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.