Individual provider Active NPI

Dianelys San Roman Parrado, APRN

  • Family Medicine Physician
  • Miami Lakes, FL
National Provider Identifier
1508523275
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11016646 Issued in FL
Practice address
14411 Commerce Way
Miami Lakes, FL 33016-1596
Phone
(786) 803-8687
NPI assigned
Nov 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11016646 FL Primary

Addresses

Primary practice location

14411 Commerce Way
Miami Lakes, FL 33016-1596

Mailing address

14411 Commerce Way Ste 300
Miami Lakes, FL 33016-1532
Phone (783) 803-8687

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
I20220722000640 FL Practitioner - Nurse Practitioner 8325429335 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016646FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Entrust Medical Group Inc CurrentSince Apr 7, 2023 Accepting new patients

Locations

14411 Commerce Way
Ste 300
Miami Lakes, FL 33016
Phone (786) 803-8687

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1508523275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 COMMERCE WAY STE 300",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161532",
            "telephone_number": "783-803-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 COMMERCE WAY",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161596",
            "telephone_number": "786-803-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN ROMAN PARRADO",
        "first_name": "DIANELYS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "11016646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.