Active NPI
Lisa Suzette Rose, DNP MSN ARNP MBA
- Family Nurse Practitioner
- Pembroke Pines, FL
National Provider Identifier
1649079104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 11037928
- Practice address
- 20380 SW 5TH St
Pembroke Pines, FL 33029-5028 - Phone
- (305) 915-1217
- NPI assigned
- Mar 10, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11037928 | FL | Primary |
Addresses
Primary practice location
20380 SW 5TH St
Pembroke Pines, FL 33029-5028
Mailing address
20380 SW 5TH St
Pembroke Pines, FL 33029-5028
Phone (305) 915-1217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Business Administration, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11037928 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1649079104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20380 SW 5TH ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330295028",
"telephone_number": "305-915-1217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20380 SW 5TH ST",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330295028",
"telephone_number": "305-915-1217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "LISA",
"middle_name": "SUZETTE",
"name_prefix": "Mrs.",
"credential": "DNP MSN ARNP MBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-10",
"last_updated": "2025-03-10",
"certification_date": "2025-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "11037928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.