Individual provider Active NPI

David Jose Trabanco, APRN, AGNP-C, FNP-C

  • Adult Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1497125520
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN9337727 Issued in FL
Practice address
10771 SW 64TH St
Miami, FL 33173-2022
Phone
(305) 271-4700
Fax
(305) 553-5271
NPI assigned
Oct 1, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9337727 FL
Family Nurse Practitioner 363LF0000X APRN9337727 FL
Gerontology Nurse Practitioner 363LG0600X APRN9337727 FL
Primary Care Nurse Practitioner 363LP2300X APRN9337727 FL
Adult Health Nurse Practitioner 363LA2200X APRN9337727 FL Primary

Addresses

Primary practice location

10771 SW 64TH St
Miami, FL 33173-2022

Mailing address

10771 SW 64TH St
Miami, FL 33173-2022
Phone (305) 271-4700

Other practice location 1

3720 SW 107th Ave Ste 1
Miami, FL 33165-3639
Phone (305) 554-6565

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
I20160502002239 FL Practitioner - Nurse Practitioner 4789985565 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9337727FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vega Health Center Inc CurrentSince May 8, 2022 Accepting new patients

Locations

3720 SW 107th Ave
Ste 1
Miami, FL 33165
Phone (305) 554-6565

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1497125520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10771 SW 64TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732022",
            "telephone_number": "305-271-4700",
            "fax_number": "305-553-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10771 SW 64TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331732022",
            "telephone_number": "305-271-4700",
            "fax_number": "305-553-5271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3720 SW 107th Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331653639",
            "country_code": "US",
            "telephone_number": "305-554-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRABANCO",
        "first_name": "DAVID",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "credential": "APRN, AGNP-C, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-01",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9337727",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9337727",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9337727",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN9337727",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9337727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.