Victoria Valentina Bazan, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11022075 Issued in FL

Practice address

9347 NW 114TH LN # 3
Hialeah Gardens, FL 33018-4269

Phone

(786) 380-3179

NPI assigned

Sep 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1497478762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9347 NW 114TH LN # 3",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184269",
            "telephone_number": "786-380-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9347 NW 114TH LN # 3",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184269",
            "telephone_number": "786-380-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "VICTORIA",
        "middle_name": "VALENTINA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "2021097385",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11022075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Hialeah Gardens, FL
• Providers in Hialeah Gardens, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.