Individual provider Active NPI

Nitchelle Montero

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1619756111
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11028796 Issued in FL
Practice address
3157 N University Dr Ste 103
Hollywood, FL 33024-2258
Phone
(954) 322-8985
Fax
(954) 322-8981
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11028796 FL Primary

Addresses

Primary practice location

3157 N University Dr Ste 103
Hollywood, FL 33024-2258

Mailing address

3157 N University Dr Ste 103
Hollywood, FL 33024-2258
Phone (954) 322-8985

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
I20240119002130 FL Practitioner - Nurse Practitioner 3375995814 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11028796FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc Nurse Practitioner CurrentSince Jan 15, 2024 Accepting new patients

Locations

5430 NW 33rd Ave
Ste 106
Ft Lauderdale, FL 33309
Phone (877) 884-8277

3720 Executive Way
Miramar, FL 33025

255 E 5th St
Ste 1050
Cincinnati, OH 45202

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1619756111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3157 N UNIVERSITY DR STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3157 N UNIVERSITY DR STE 103",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242258",
            "telephone_number": "954-322-8985",
            "fax_number": "954-322-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTERO",
        "first_name": "NITCHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11028796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.