Individual provider Active NPI

Shorraine Daubon, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1649738840
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9349781 Issued in FL
Practice address
20503 NW 14TH PL
Miami, FL 33169-2462
Phone
(786) 278-1967
NPI assigned
Mar 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 APRN9349781 FL Primary

Addresses

Primary practice location

20503 NW 14TH PL
Miami, FL 33169-2462

Mailing address

20503 NW 14TH PL
Miami, FL 33169-2462
Phone (786) 278-1967

Other names 1

  • Shorraine Gordon Former name

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
I20220921001149 FL Practitioner - Nurse Practitioner 9537544994 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pembroke Pines Community Health Center Inc CurrentSince Sep 1, 2022 Accepting new patients
Cleopatra Gordon Pusey, MD P.a. CurrentSince Sep 1, 2022 Accepting new patients

Locations

1100 S 56th Ave
Hollywood, FL 33023
Phone (954) 357-2353

222 S Flamingo Rd
Pembroke Pines, FL 33027
Phone (954) 392-9026

Interoperability endpoints

  • Direct secure messaging: shorraine.daubon@135727558033412.direct.elationemr.com

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": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1649738840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20503 NW 14TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331692462",
            "telephone_number": "786-278-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20503 NW 14TH PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331692462",
            "telephone_number": "786-278-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBON",
        "first_name": "SHORRAINE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9349781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHORRAINE",
            "last_name": "GORDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.