Individual provider Active NPI

Salvador Jesus Nunez Beris, FNP

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1609540368
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014529 Issued in FL
Practice address
2417 US Highway 98 N
Lakeland, FL 33805-2410
Phone
(305) 534-0076
NPI assigned
Aug 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 11014529 FL Primary

Addresses

Primary practice location

2417 US Highway 98 N
Lakeland, FL 33805-2410

Mailing address

1400 NW 107TH Ave Ste 500
Sweetwater, FL 33172-2746
Phone (305) 534-0076

Other practice location 1

205 1st St S
Winter Haven, FL 33880-3255
Phone (305) 534-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11014529FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ubaldo a Miranda MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: salvador.nunez.beris.1@24158.direct.athenahealth.com

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1609540368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 107TH AVE STE 500",
            "city": "SWEETWATER",
            "state": "FL",
            "postal_code": "331722746",
            "telephone_number": "305-534-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052410",
            "telephone_number": "305-534-0076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 1st St S",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338803255",
            "country_code": "US",
            "telephone_number": "305-534-0076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNEZ BERIS",
        "first_name": "SALVADOR",
        "middle_name": "JESUS",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.