Individual provider Active NPI

Edzer Desarmes, APRN

  • Family Nurse Practitioner
  • Atlantis, FL
National Provider Identifier
1669002382
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11005810 Issued in FL
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

Updated by the provider on Aug 17, 2021

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008002234 FL Order and Referring Only - Nurse Practitioner 7911327762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11005810FLMDFamily 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

Verify at the official NPI Registry.