Individual provider Active NPI

Yudith Simon-Canellas, FNP

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1659738318
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9400138 Issued in FL
Practice address
1325 SE 47TH St
Cape Coral, FL 33904-9692
Phone
(239) 205-2337
Fax
(239) 310-5287
NPI assigned
Jan 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X ARNP 9400138 FL
Family Nurse Practitioner 363LF0000X APRN9400138 FL Primary

Addresses

Primary practice location

1325 SE 47TH St
Cape Coral, FL 33904-9692

Mailing address

1525 SE 5TH CT
Cape Coral, FL 33990-2019
Phone (305) 803-4502

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
I20210623003932 FL Practitioner - Nurse Practitioner 9537560800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9400138FLMDFamily Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1659738318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 SE 5TH CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902019",
            "telephone_number": "305-803-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SE 47TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049692",
            "telephone_number": "239-205-2337",
            "fax_number": "239-310-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON-CANELLAS",
        "first_name": "YUDITH",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "FL",
            "license": "ARNP 9400138",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9400138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.