Individual provider Active NPI

Katia Rancol Borrero

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1487415956
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11030733 Issued in FL
Practice address
3609 Marco Dr
Tampa, FL 33614-2746
Phone
(502) 996-3426
NPI assigned
Jan 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 11030733 FL Primary

Addresses

Primary practice location

3609 Marco Dr
Tampa, FL 33614-2746

Mailing address

3609 Marco Dr
Tampa, FL 33614-2746

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
I20240213003740 FL Practitioner - Nurse Practitioner 6103260591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

1507 S Tuttle Ave
Sarasota, FL 34239-2608
Phone (732) 552-8922

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11030733FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd Florida P.a. CurrentSince Aug 1, 2024 Accepting new patients
Mana Health Partners PA CurrentSince Feb 1, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

1061 Virginia St
Dunedin, FL 34698
Phone (727) 733-4189

1059 Virginia St
Dunedin, FL 34698
Phone (727) 733-6091

6700 NW 10th Pl
Gainesville, FL 32605
Phone (352) 240-6402

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

3865 Tampa Rd
Oldsmar, FL 34677
Phone (516) 680-8080

1317 Edgewater Dr
Orlando, FL 32804
Phone (877) 436-8527

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1487415956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 MARCO DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 MARCO DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142746",
            "telephone_number": "502-996-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANCOL BORRERO",
        "first_name": "KATIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11030733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.