Active NPI
Edzer Desarmes, APRN
- Family Nurse Practitioner
- Atlantis, FL
National Provider Identifier
1669002382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11005810
- Practice address
- 5401 S Congress Ave Ste 201
Atlantis, FL 33462-6637 - Phone
- (561) 995-6971
- Fax
- (561) 569-8309
- NPI assigned
- Jan 22, 2020
- Sex
- Male
- Sole proprietor
- No
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 | APRN11005810 | FL | Primary |
Addresses
Primary practice location
5401 S Congress Ave Ste 201
Atlantis, FL 33462-6637
Mailing address
20423 State Road 7 Ste F6
Boca Raton, FL 33498-6792
Phone (561) 995-6971
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241008002234 | FL | Order and Referring Only - Nurse Practitioner | 7911327762 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11005810 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1669002382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20423 STATE ROAD 7 STE F6",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334986792",
"telephone_number": "561-995-6971",
"fax_number": "561-569-8309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 S CONGRESS AVE STE 201",
"city": "ATLANTIS",
"state": "FL",
"postal_code": "334626637",
"telephone_number": "561-995-6971",
"fax_number": "561-569-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESARMES",
"first_name": "EDZER",
"name_prefix": "Mr.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-22",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11005810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlantis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.