Individual provider Active NPI

Cynthia Hazim-Camacho, APRN

  • Adult Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1548855455
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11011901 Issued in FL
Practice address
1150 N University Dr
Pembroke Pines, FL 33024-5031
Phone
(954) 616-2020
NPI assigned
Mar 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11011901 FL Primary

Addresses

Primary practice location

1150 N University Dr
Pembroke Pines, FL 33024-5031

Mailing address

17816 SW 10TH LN
Pembroke Pines, FL 33029-4404
Phone (786) 442-7333

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Fmcone@gmail.com Direct

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
I20210420002181 FL Practitioner - Nurse Practitioner 9931517521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Associates of South Florida, P.a.Group PAC ID 3577759893, 3 clinicians

Practice addresses (Care Compare)

1380 NE Miami Gardens Dr
Suite 100
North Miami Beach, FL 33179-4708
Phone (305) 940-6973

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11011901FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of South Florida, P.a. CurrentSince Mar 10, 2023 Accepting new patients

Locations

1380 NE Miami Gardens Dr
Ste 100
North Miami Beach, FL 33179
Phone (305) 940-6973

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": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1548855455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17816 SW 10TH LN",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330294404",
            "telephone_number": "786-442-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245031",
            "telephone_number": "954-616-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZIM-CAMACHO",
        "first_name": "CYNTHIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11011901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Fmcone@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Practice email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1150 N University Dr",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330245031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.