Individual provider Active NPI

Brandy Serret Quintana, ARNP

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1538647672
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9392964 Issued in FL
Practice address
2706 W Saint Isabel St
Tampa, FL 33607-6382
Phone
(786) 313-3558
NPI assigned
Jul 31, 2018
Last updated
May 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9392964 FL Primary

Addresses

Primary practice location

2706 W Saint Isabel St
Tampa, FL 33607-6382

Mailing address

460 E 23Rd St Apt 417
Hialeah, FL 33013-3936
Phone (786) 372-2462

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
I20200626001253 FL Practitioner - Nurse Practitioner 4981026515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9392964FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well-Being Community Center, Corp. CurrentSince May 1, 2020 Accepting new patients

Locations

2706 W Saint Isabel St
Tampa, FL 33607
Phone (813) 769-9571

Interoperability endpoints

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

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1538647672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E 23RD ST APT 417",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133936",
            "telephone_number": "786-372-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 W SAINT ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076382",
            "telephone_number": "786-313-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRET QUINTANA",
        "first_name": "BRANDY",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9392964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.