Individual provider Active NPI

Ruben Valderrama, ARNP

  • Family Nurse Practitioner
  • Homestead, FL
National Provider Identifier
1528570223
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9387370 Issued in FL
Practice address
1541 SE 12TH Ave Ste 28-29
Homestead, FL 33034-2699
Phone
(786) 640-1424
Fax
(786) 601-7124
NPI assigned
Nov 2, 2017
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 9387370 FL Primary

Addresses

Primary practice location

1541 SE 12TH Ave Ste 28-29
Homestead, FL 33034-2699

Mailing address

19932 SW 132ND PL
Miami, FL 33177-2929
Phone (305) 761-5968

Other practice location 1

19932 SW 132nd Pl
Miami, FL 33177-2929
Phone (305) 761-5968

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
I20190621000583 FL Practitioner - Nurse Practitioner 2264766450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1541 SE 12TH Ave
Suite 29
Homestead, FL 33034-2699
Phone (786) 640-1424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9387370FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sina Medical Center LLC CurrentSince Sep 2, 2022 Accepting new patients

Locations

1541 SE 12th Ave
Ste 2829
Homestead, FL 33034
Phone (786) 308-8091

1541 SE 12th Ave
Ste 29
Homestead, FL 33034
Phone (305) 242-0360

Interoperability endpoints

  • Direct secure messaging: ms_rvalder5@landmarkhealth-direct.org

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, 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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1528570223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19932 SW 132ND PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331772929",
            "telephone_number": "305-761-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 SE 12TH AVE STE 28-29",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330342699",
            "telephone_number": "786-640-1424",
            "fax_number": "786-601-7124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19932 SW 132nd Pl",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331772929",
            "country_code": "US",
            "telephone_number": "305-761-5968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDERRAMA",
        "first_name": "RUBEN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-02",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9387370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

Verify at the official NPI Registry.