Individual provider Active NPI

Aliki Vasiliadi-Broit, ARNP

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1407260375
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9272762 Issued in FL
Practice address
18425 Pines Blvd
Pembroke Pines, FL 33029-1415
Phone
(954) 430-9300
Fax
(954) 450-2883
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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 ARNP9272762 FL Primary

Addresses

Primary practice location

18425 Pines Blvd
Pembroke Pines, FL 33029-1415

Mailing address

900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (954) 430-9300

Other identifiers 1

IdentifierTypeStateIssuer
018602800MedicaidFL

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9272762FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1407260375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "954-430-9300",
            "fax_number": "954-450-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18425 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291415",
            "telephone_number": "954-430-9300",
            "fax_number": "954-450-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILIADI-BROIT",
        "first_name": "ALIKI",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9272762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018602800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.