Individual provider Active NPI

Lazara Dailes Maqueira, FNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1639892904
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11018130 Issued in FL
Practice address
7609 Sharon Dr
Tampa, FL 33617-8105
Phone
(813) 325-8038
NPI assigned
Sep 22, 2022
Last updated
Sep 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 11018130 FL Primary

Addresses

Primary practice location

7609 Sharon Dr
Tampa, FL 33617-8105

Mailing address

7609 Sharon Dr
Tampa, FL 33617-8105
Phone (813) 325-8038

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
I20221115001036 FL Practitioner - Nurse Practitioner 8426426966

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018130FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1639892904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7609 SHARON DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336178105",
            "telephone_number": "813-325-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7609 SHARON DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336178105",
            "telephone_number": "813-325-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAQUEIRA",
        "first_name": "LAZARA",
        "middle_name": "DAILES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.