Junior Manuel Peralta Pena, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11014221 Issued in FL

Practice address

9050 Pines Blvd Ste 150
Pembroke Pines, FL 33024-6400

Phone

(954) 872-0555

NPI assigned

Aug 7, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Guidewell Sanitas I, LLC

  • Family Medicine Physician
  • Doral, FL
  • NPI 1396124046
  Medicare reassignment NPD
• Hope 2020 Inc

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1154947232
  Medicare reassignment NPD
• Brain Wellness and Mental Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hialeah, FL
  • NPI 1336084706
  NPD Authorized official
• Guidewell Sanitas I, LLC

  • Multi-Specialty Clinic/Center
  • North Miami Beach, FL
  • NPI 1598311516
  NPD
• R & C Psychiatry and Integrative Medicine LLC

  • Psychiatry Physician
  • Pembroke Pines, FL
  • NPI 1134833163

  Psychiatric/Mental Health

  NPD

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

{
    "created_epoch": "1628294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1487328910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 W 12TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122266",
            "telephone_number": "786-778-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 PINES BLVD STE 150",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246400",
            "telephone_number": "954-872-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18373 NW 27th Ave",
            "address_purpose": "LOCATION",
            "city": "Carol City",
            "state": "FL",
            "postal_code": "330563169",
            "country_code": "US",
            "telephone_number": "786-778-0968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "486 Fisherman St",
            "address_purpose": "LOCATION",
            "city": "Opa Locka",
            "state": "FL",
            "postal_code": "330543818",
            "country_code": "US",
            "telephone_number": "786-778-0968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERALTA PENA",
        "first_name": "JUNIOR",
        "middle_name": "MANUEL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-07",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014221",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11014221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Business",
            "affiliation": "N",
            "address_1": "9050 Pines Blvd Ste 150",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330246400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Penstar Provider Network LLC
• Mythili Penugonda, MD
• Peony Home Aide Agency LLC
• People Empowering People, PA
• Cindy Pepin, FNP
• Dihloren Antonia Peralta-Lee, MD
• Adriana Peralta, MSW
• Annaliz Peralta
• Michelle Nicole Peralta, RMHCI
• Siji Jimmy Perappadan

• Psychiatric/Mental Health Nurse Practitioner in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.