Individual provider Active NPI

Ivonne Liliana Peralta, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1669304952
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11045757 Issued in FL
Practice address
8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863
Phone
(904) 493-3390
Fax
(904) 493-3395
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11045757 FL Primary

Addresses

Primary practice location

8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863

Mailing address

121 Caribbean PL
Saint Johns, FL 32259-2296
Phone (904) 493-3390

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
I20260609002051 FL Practitioner - Nurse Practitioner 8325519432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jacksonville Hospitalists PAGroup PAC ID 3274591631, 19 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32217
Phone (904) 493-3390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11045757FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Symphony Specialty Group, LLC Single Specialty CurrentSince Jun 1, 2026 Accepting new patients
Jacksonville Hospitalists PA Single Specialty CurrentSince Jun 1, 2026 Accepting new patients

Locations

8613 Old Kings Rd S
Ste 602
Jacksonville, FL 32217
Phone (904) 493-3390

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1669304952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CARIBBEAN PL",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322592296",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD S STE 602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174863",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "IVONNE",
        "middle_name": "LILIANA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11045757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.