Active NPI
Your Favorite NP Consultant
- Primary Care Clinic/Center
- Winter Haven, FL
National Provider Identifier
1669126488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Davida Nicole Miller, FNP-C
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Nurse Practitioner
- Winter Haven, FL
- NPI 1063835122
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.