Organization Active NPI

Your Favorite NP Consultant

  • Primary Care Clinic/Center
  • Winter Haven, FL
National Provider Identifier
1669126488
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
YOUR FAVORITE NP CONSULTANT
Practice address
757 Cypress Gardens Blvd
Winter Haven, FL 33880-4712
Phone
(863) 268-6180
NPI assigned
Feb 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Authorized official

Name
Davida Nicole Miller, FNP-CNPI 1063835122
Title
Ceo
Phone
(863) 268-6180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X Primary
Rural Health Clinic/Center 261QR1300X
VA Clinic/Center 261QV0200X
Point of Service 305S00000X

Addresses

Primary practice location

757 Cypress Gardens Blvd
Winter Haven, FL 33880-4712

Mailing address

1651 Marshall Rd SW
Winter Haven, FL 33880-1955
Phone (863) 268-6180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250429003205 FL Part B Supplier - Clinic/Group Practice 7416473772 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Haven, FL

National Provider Directory

National Provider Directory

Locations

757 Cypress Gardens Blvd
Winter Haven, FL 33880
Phone (863) 268-6180

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1669126488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 MARSHALL RD SW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338801955",
            "telephone_number": "863-268-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804712",
            "telephone_number": "863-268-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR FAVORITE NP CONSULTANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAVIDA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-268-6180",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.