Individual provider Active NPI

Rosa Maria Avila, APRN

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1407518103
Registry record updated Oct 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015638 Issued in FL
Practice address
19562 NW 79TH PL
Hialeah, FL 33015-6338
Phone
(786) 286-6445
NPI assigned
Oct 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2021

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 11015638 FL Primary

Addresses

Primary practice location

19562 NW 79TH PL
Hialeah, FL 33015-6338

Mailing address

19562 NW 79TH PL
Hialeah, FL 33015-6338
Phone (786) 286-6445

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
I20260209003155 FL Practitioner - Nurse Practitioner 6103305263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 NE Miami Gardens Dr
Miami, FL 33179-4900

19562 NW 79TH PL
Hialeah, FL 33015-6338

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015638FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pasteur & Wellmax Medical Centers LLC CurrentSince Jan 6, 2026 Accepting new patients
Pasteur & Wellmax Medical Centers LLC CurrentSince Jan 6, 2026 Accepting new patients

Locations

1600 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 919-1970

1500 S Hiatus Rd
Pembroke Pines, FL 33025
Phone (954) 438-4000

6355 NW 36th St
Ste 1100
Virginia Gardens, FL 33166

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633824000000",
    "number": "1407518103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19562 NW 79TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330156338",
            "telephone_number": "786-286-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19562 NW 79TH PL",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330156338",
            "telephone_number": "786-286-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "ROSA",
        "middle_name": "MARIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-10",
        "last_updated": "2021-10-10",
        "certification_date": "2021-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.