Individual provider Active NPI

Vanessa Valles, APRN, FNP-C

  • Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1487088043
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9170390 Issued in FL
Practice address
880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone
(866) 849-0692
Fax
(888) 973-8821
NPI assigned
Aug 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5023694 NC
Nurse Practitioner 363L00000X APRN.CNP.0038716 OH
Nurse Practitioner 363L00000X 1110297 TX
Nurse Practitioner 363L00000X 36439 TN
Nurse Practitioner 363L00000X ARNP9170390 FL Primary
Nurse Practitioner 363L00000X 3-001615 AL

Addresses

Primary practice location

880 SW 145TH Ave Ste 202
Pembroke Pines, FL 33027-6171

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

Other identifiers 1

IdentifierTypeStateIssuer
009586000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL, TX, TN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20130923000341 FL Practitioner - Nurse Practitioner 4789828302 Reassigns benefits to 1 organization
I20240216000367 AL Practitioner - Nurse Practitioner 4789828302
I20240226000571 TX Practitioner - Nurse Practitioner 4789828302 Reassigns benefits to 1 organization
I20241030003598 TN Practitioner - Nurse Practitioner 4789828302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5023694NCMDNurse Practitioner
APRN.CNP.0038716OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Devoted Medical Group of Texas Inc CurrentSince Feb 8, 2024 Accepting new patients
Devoted Medical Group Professional Corporation CurrentSince Aug 1, 2022 Accepting new patients
St Anthony'S Primary Care LLC CurrentSince Sep 16, 2013 Accepting new patients

Locations

880 SW 145th Ave
Ste 202
Pembroke Pines, FL 33027
Phone (615) 275-6612

560 Jackson St N
Ste 302
St Petersburg, FL 33705
Phone (727) 820-7701

116 1st St N
St Petersburg, FL 33701
Phone (727) 895-5210

1201 5th Ave N
Ste 408
St Petersburg, FL 33705
Phone (727) 894-3733

509 Jackson St N
St Petersburg, FL 33705
Phone (727) 820-7800

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

3200 West End Ave
Nashville, TN 37203
Phone (615) 510-1646

1201 Fannin St
Ste 262
Houston, TX 77002
Phone (714) 873-6202

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1487088043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SW 145TH AVE STE 202",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330276171",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLES",
        "first_name": "VANESSA",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5023694",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0038716",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1110297",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "36439",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9170390",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "3-001615",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009586000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.