Individual provider Active NPI

Simone Maria Burgos-Juteram, ARNP

  • Adult Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1457623555
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP2614312 Issued in FL
Practice address
10794 Pines Blvd
Boulevard Proffessional Centre
Pembroke Pines, FL 33026-3920
Phone
(954) 704-4988
NPI assigned
Feb 3, 2012
Last updated
Feb 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP2614312 FL Primary

Addresses

Primary practice location

10794 Pines Blvd
Boulevard Proffessional Centre
Pembroke Pines, FL 33026-3920

Mailing address

1101 NW 155TH Ter
Pembroke Pines, FL 33028-1581
Phone (954) 292-3525

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
I20231209000484 FL Practitioner - Nurse Practitioner 1052639713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP2614312FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Simone Psychcare LLC Current Accepting new patients
Grow Healthcare Group PA CurrentSince Oct 1, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1457623555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NW 155TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281581",
            "telephone_number": "954-292-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10794 PINES BLVD",
            "address_2": "BOULEVARD PROFFESSIONAL CENTRE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263920",
            "telephone_number": "954-704-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS-JUTERAM",
        "first_name": "SIMONE",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP2614312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.