Individual provider Active NPI

Jeffly Glace, ARNP

  • Critical Care Neonatal Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1508500109
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
APRN11018879 Issued in FL
Practice address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone
(305) 661-1515
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X APRN11018879 FL
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN11018879 FL Primary

Addresses

Primary practice location

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423

Mailing address

7440 N Kendall Dr Apt 3523
Miami, FL 33156-8083
Phone (786) 780-4582

Other practice location 1

6200 SW 73rd St
South Miami, FL 33143-4679
Phone (786) 780-4582

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
I20231214000004 FL Practitioner - Nurse Practitioner 7810346947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11018879FLMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Dade County Florida CurrentSince Dec 11, 2023 Accepting new patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Dec 11, 2023 Accepting new patients
Public Health Trust of Dade County Florida Past Accepting new patients

Locations

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

1611 NW 12th Ave
Ste 600B
Miami, FL 33136
Phone (305) 355-1303

Organizations & group practices 4

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1508500109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 N KENDALL DR APT 3523",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331568083",
            "telephone_number": "786-780-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 SW 73rd St",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434679",
            "country_code": "US",
            "telephone_number": "786-780-4582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLACE",
        "first_name": "JEFFLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "APRN11018879",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "FL",
            "license": "APRN11018879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.