Individual provider Active NPI

Angela Patricia Salazar de Torres, FNP-BC

  • Family Nurse Practitioner
  • Fern Park, FL
National Provider Identifier
1497338701
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11012882 Issued in FL
Practice address
2915 Lakeview Dr Ste 1001
Fern Park, FL 32730-2050
Phone
(074) 900-0613
Fax
(407) 335-6945
NPI assigned
May 4, 2021
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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 11012882 FL Primary

Addresses

Primary practice location

2915 Lakeview Dr Ste 1001
Fern Park, FL 32730-2050

Mailing address

2915 Lakeview Dr Ste 1001
Fern Park, FL 32730-2050
Phone (407) 900-0613

Other identifiers 1

IdentifierTypeStateIssuer
P2753OtherFLHF MA

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
I20221115000987 FL Practitioner - Nurse Practitioner 4082082524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11012882FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Florida, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

2915 Lakeview Dr
Ste 1001
Fern Park, FL 32730
Phone (407) 900-0613

140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1497338701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 LAKEVIEW DR STE 1001",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302050",
            "telephone_number": "407-900-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 LAKEVIEW DR STE 1001",
            "city": "FERN PARK",
            "state": "FL",
            "postal_code": "327302050",
            "telephone_number": "074-900-0613",
            "fax_number": "407-335-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR DE TORRES",
        "first_name": "ANGELA",
        "middle_name": "PATRICIA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HF MA",
            "identifier": "P2753",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fern Park, FL

Sources for this page

Verify at the official NPI Registry.