Individual provider Active NPI

Adianez Garcia Aguila, FNP-BC

  • Primary Care Nurse Practitioner
  • Palm Coast, FL
National Provider Identifier
1497479083
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN11019208 Issued in FL
Practice address
203 Palmwood Dr
Palm Coast, FL 32164-1501
Phone
(786) 298-4573
NPI assigned
Sep 28, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11019208 FL Primary

Addresses

Primary practice location

203 Palmwood Dr
Palm Coast, FL 32164-1501

Mailing address

203 Palmwood Dr
Palm Coast, FL 32164-1501

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
I20230829000154 FL Practitioner - Nurse Practitioner 3375906050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15600 SW 288TH St
Suite 105
Homestead, FL 33033-1223
Phone (786) 706-5938

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11019208FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Practitioners & Associates LLC CurrentSince Nov 6, 2023 Accepting new patients
Mart Medical Group Inc CurrentSince Jul 31, 2024 Accepting new patients

Locations

15600 SW 288th St
Ste 105
Homestead, FL 33033
Phone (786) 298-4573

7311 NW 36th St
Unit 7311
Miami, FL 33166
Phone (786) 640-0602

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJDHDD/Endpoint/IJDHDD

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, 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": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1497479083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 PALMWOOD DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321641501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PALMWOOD DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321641501",
            "telephone_number": "786-298-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA AGUILA",
        "first_name": "ADIANEZ",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11019208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.