Individual provider Active NPI

Marilyn Dellagloria, ARNP

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Miami, FL
National Provider Identifier
1659369171
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
ARNP1460542 Issued in FL
Practice address
11440 N Kendall Drive
Suite 208
Miami, FL 33176-1024
Phone
(888) 852-6672
Fax
(305) 891-4228
NPI assigned
Oct 10, 2005
Last updated
Aug 19, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP1460542 FL
Clinical Nurse Specialist 364S00000X ARNP1460542 FL
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X ARNP1460542 FL
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X ARNP1460542 FL Primary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X ARNP1460542 FL

Addresses

Primary practice location

11440 N Kendall Drive
Suite 208
Miami, FL 33176-1024

Mailing address

1065 NE 125TH St Ste 409
North Miami, FL 33161-5834
Phone (888) 852-6672

Other identifiers 2

IdentifierTypeStateIssuer
P01078749OtherFLMEDICARE RAILROAD
303398800MedicaidFL

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
I20101213001116 FL Practitioner - Nurse Practitioner 1557558863 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Impower, Inc CurrentSince Jun 25, 2024 Accepting new patients

Locations

2290 N Ronald Reagan Blvd
Ste 116
Longwood, FL 32750
Phone (407) 215-0095

580 Old Sanford Oviedo Rd
Winter Springs, FL 32708
Phone (407) 215-0095

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1659369171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11440 N KENDALL DRIVE",
            "address_2": "SUITE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761024",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLAGLORIA",
        "first_name": "MARILYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1460542",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "FL",
            "license": "ARNP1460542",
            "primary": false
        },
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "FL",
            "license": "ARNP1460542",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1460542",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "ARNP1460542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01078749",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303398800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.