Individual provider Active NPI

Eduardo E Nieto, ARNP

  • Primary Care Nurse Practitioner
  • Coconut Creek, FL
National Provider Identifier
1659150001
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F08230440 Issued in FL
Practice address
3850 Coconut Creek Pkwy Ste 3
Coconut Creek, FL 33066-1600
Phone
(954) 973-9222
Fax
(954) 973-7135
NPI assigned
Sep 25, 2023
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F08230440 FL
Primary Care Nurse Practitioner 363LP2300X F08230440 FL Primary

Addresses

Primary practice location

3850 Coconut Creek Pkwy Ste 3
Coconut Creek, FL 33066-1600

Mailing address

3850 Coconut Creek Pkwy Ste 3
Coconut Creek, FL 33066-1600
Phone (954) 973-9222

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
I20240409000549 FL Practitioner - Nurse Practitioner 6002254125 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F08230440FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Health Group of South Florida Inc CurrentSince Mar 8, 2024 Accepting new patients

Locations

3850 Coconut Creek Pkwy
Ste 3
Coconut Creek, FL 33066
Phone (954) 973-9222

7353 NW 4th St
Plantation, FL 33317
Phone (954) 581-7171

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1741651200000",
    "number": "1659150001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 COCONUT CREEK PKWY STE 3",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661600",
            "telephone_number": "954-973-9222",
            "fax_number": "954-973-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 COCONUT CREEK PKWY STE 3",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661600",
            "telephone_number": "954-973-9222",
            "fax_number": "954-973-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "EDUARDO",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F08230440",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "F08230440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.