Individual provider Active NPI

Liza Guillen, APRN

  • Family Nurse Practitioner
  • Davie, FL
National Provider Identifier
1497419923
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11016358 Issued in FL
Practice address
4301 S Flamingo Rd
Davie, FL 33330-1902
Phone
(954) 640-1200
NPI assigned
Oct 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 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 11016358 FL Primary

Addresses

Primary practice location

4301 S Flamingo Rd
Davie, FL 33330-1902

Mailing address

4301 S Flamingo Rd
Davie, FL 33330-1902

Other practice location 1

1751 Bonaventure Blvd
Weston, FL 33326-4039
Phone (954) 656-3181

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
I20220308000840 FL Practitioner - Nurse Practitioner 5991199911 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inphynet South Broward LLCGroup PAC ID 4587563960, 67 clinicians
Quick Family Urgentcare, LLCGroup PAC ID 2062550700, 6 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-2000

4301 S Flamingo Rd
Suite 102
Davie, FL 33330-1902
Phone (954) 640-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016358FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet South Broward LLC Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
University of Miami CurrentSince Jul 1, 2022 Accepting new patients
Quick Family Urgentcare, LLC Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
University of Miami Current Accepting new patients
Inphynet Contracting Services LLC CurrentSince Oct 1, 2025 Accepting new patients
University of Miami CurrentSince Jul 1, 2022 Accepting new patients

Locations

4301 S Flamingo Rd
Davie, FL 33330
Phone (954) 312-3449

4301 S Flamingo Rd
Ste 102
Davie, FL 33330
Phone (954) 370-2135

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

801 S Douglas Rd
Pembroke Pines, FL 33025
Phone (954) 276-6500

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

1751 Bonaventure Blvd
Weston, FL 33326
Phone (954) 385-0014

Interoperability endpoints

  • Direct secure messaging: liza.guillen@478600780382212.direct.elationemr.com

Organizations & group practices 6

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": "1635638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1497419923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S FLAMINGO RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333301902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S FLAMINGO RD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333301902",
            "telephone_number": "954-640-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1751 Bonaventure Blvd",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "FL",
            "postal_code": "333264039",
            "country_code": "US",
            "telephone_number": "954-656-3181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "LIZA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-31",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.