Individual provider Active NPI

Eglis Tomas Carralero, APRN

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1619634672
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11016702 Issued in FL
Practice address
3429 W 80TH St Apt 205
Hialeah, FL 33018-7571
Phone
(407) 731-7279
NPI assigned
Nov 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1138159 TX
Nurse Practitioner 363L00000X APRN11016702 FL
Family Nurse Practitioner 363LF0000X APRN11016702 FL Primary

Addresses

Primary practice location

3429 W 80TH St Apt 205
Hialeah, FL 33018-7571

Mailing address

9700 Leawood Blvd Apt 1505
Houston, TX 77099-2662
Phone (407) 731-7279

Other practice location 1

336 NW 5th St
Miami, FL 33128-1616
Phone (305) 577-4840

Other identifiers 1

IdentifierTypeStateIssuer
121211600MedicaidFL

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
I20221121000166 FL Practitioner - Nurse Practitioner 4981072113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camillus Health Concern IncGroup PAC ID 4688575210, 15 clinicians

Practice addresses (Care Compare)

336 NW 5TH St
Miami, FL 33128-1616
Phone (305) 477-4840

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1138159TXMDRegistered Nurse
APRN11016702FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camillus Health Concern, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Camillus Health Concern Inc CurrentSince Feb 5, 2024 Accepting new patients

Locations

336 NW 5th St
Miami, FL 33128
Phone (305) 477-4840

Organizations & group practices 2

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": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1619634672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 LEAWOOD BLVD APT 1505",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992662",
            "telephone_number": "407-731-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3429 W 80TH ST APT 205",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330187571",
            "telephone_number": "407-731-7279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 NW 5th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331281616",
            "country_code": "US",
            "telephone_number": "305-577-4840",
            "fax_number": "305-373-7431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMAS CARRALERO",
        "first_name": "EGLIS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-24",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1138159",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11016702",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11016702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121211600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.