Lys Maike Ice, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11012671 Issued in FL

Practice address

853 Sunridge Point Dr
Seffner, FL 33584-5915

Phone

(740) 538-1100

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1548976830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 SUNRIDGE POINT DR",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335845915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 SUNRIDGE POINT DR",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335845915",
            "telephone_number": "740-538-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "LYS",
        "middle_name": "MAIKE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11012671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holiday CVS LLC
• Diane M Hooks
• Hope Speech Therapy Solutions, LLC
• Keilah Hudson
• Kimberley Hunt
• Idelis Fedeslinda Arias de la Torre
• Ruxandra Ivascu, PHARMD
• Sharica Y Jackson
• Holly Jansen, M.S. CCC-SLP
• Kamillia Kasndra Jefferies

• Family Nurse Practitioner in Seffner, FL
• Providers in Seffner, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.