Consolacion Liceth Becerra, RN-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

11025765 Issued in FL

Practice address

100 Park Place Blvd Ste 201
Kissimmee, FL 34741-2326

Phone

(407) 766-4519

NPI assigned

May 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mrs. Consolacion Liceth Huerfano Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1619405461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK PLACE BLVD STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412326",
            "telephone_number": "407-766-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK PLACE BLVD STE 201",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412326",
            "telephone_number": "407-766-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "CONSOLACION",
        "middle_name": "LICETH",
        "name_prefix": "Ms.",
        "credential": "RN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9175391",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11025765",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11025765",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "11025765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSOLACION",
            "last_name": "HUERFANO",
            "middle_name": "LICETH",
            "prefix": "MRS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Primary Care Nurse Practitioner in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.