Individual provider Active NPI

Pascual Mora, APRN FNP-C

  • Family Nurse Practitioner
  • Cutler Bay, FL
National Provider Identifier
1639844871
Registry record updated Jul 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11014696 Issued in FL
Practice address
10041 Haitian Dr
Cutler Bay, FL 33189-1647
Phone
(786) 486-9896
NPI assigned
Aug 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2024

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 APRN11014696 FL Primary

Addresses

Primary practice location

10041 Haitian Dr
Cutler Bay, FL 33189-1647

Mailing address

10041 Haitian Dr
Cutler Bay, FL 33189-1647
Phone (786) 486-9896

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
I20240802003030 FL Practitioner - Nurse Practitioner 6002074606 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

Practice addresses (Care Compare)

2387 W 68TH St
Suite 201
Hialeah, FL 33016-6890
Phone (305) 557-8486

National Provider Directory

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

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720915200000",
    "number": "1639844871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10041 HAITIAN DR",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331891647",
            "telephone_number": "786-486-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10041 HAITIAN DR",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331891647",
            "telephone_number": "786-486-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "PASCUAL",
        "credential": "APRN FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11014696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

Verify at the official NPI Registry.