Phara Desravines

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

354035 Issued in NY

Practice address

1154 NW 100TH Ave
Pembroke Pines, FL 33024-4376

Phone

(305) 336-7457

NPI assigned

May 6, 2024

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1467209510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 NW 100TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330244376",
            "telephone_number": "305-336-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1154 NW 100TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330244376",
            "telephone_number": "305-336-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESRAVINES",
        "first_name": "PHARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "354035",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "354035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anup Desai, FNP-C
• Shreena Jatin Desai, DO
• Nelson Descamps, RBT
• Lisa Deshommes
• Rigaud Desir Jr., CRC, CVE, LMHC, NCC
• Nagela Desruisseaux Pierre
• Nancy P Destin, PT
• Yehuda E Deutsch, M.D.
• Deveaux Group Incorporated (A Joyful Heart Senior Services)
• Corlette Deveaux

• Family Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.