Individual provider Active NPI

Penelope Ann Cuoco, A.R.N.P.

  • Family Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1457343519
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP1521692 Issued in FL
Practice address
500 N Hiatus Rd Ste 201
Pembroke Pines, FL 33026-5213
Phone
(954) 381-8989
Fax
(954) 381-8950
NPI assigned
Aug 16, 2005
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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 ARNP1521692 FL Primary

Addresses

Primary practice location

500 N Hiatus Rd Ste 201
Pembroke Pines, FL 33026-5213

Mailing address

500 N Hiatus Rd Ste 201
Pembroke Pines, FL 33026-5213
Phone (954) 381-8989

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
I20040102000416 FL Practitioner - Nurse Practitioner 0446159032 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP1521692FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC CurrentSince Oct 1, 2022 Accepting new patients
Corus Advantage Solutions, LLC PastSince May 9, 2021 Accepting new patients
Dr. Joseph Christian Hadeed PastSince Jan 1, 1990 Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

500 N Hiatus Rd
Ste 201
Pembroke Pines, FL 33026
Phone (954) 381-8989

700 N Hiatus Rd
Ste 209
Pembroke Pines, FL 33026
Phone (305) 206-1690

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1457343519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD STE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-381-8989",
            "fax_number": "954-381-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD STE 201",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-381-8989",
            "fax_number": "954-381-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUOCO",
        "first_name": "PENELOPE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1521692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.