Individual provider Active NPI

Ilen Diaz, ARNP

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1669953535
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9350669 Issued in FL
Practice address
16514 SW 19TH St
Miramar, FL 33027-4466
Phone
(786) 270-9389
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 ARNP9350669 FL Primary

Addresses

Primary practice location

16514 SW 19TH St
Miramar, FL 33027-4466

Mailing address

16514 SW 19TH St
Miramar, FL 33027-4466
Phone (786) 270-9389

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
I20190211002764 FL Practitioner - Nurse Practitioner 6305184755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Derm Group LLPGroup PAC ID 9335478908, 32 clinicians

Practice addresses (Care Compare)

14601 SW 29TH St
Suite 206
Miramar, FL 33027-4714
Phone (954) 885-5551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9350669FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Francisco Flores MD PA CurrentSince Jan 1, 2019 Accepting new patients
The Derm Group LLP CurrentSince Sep 1, 2019 Accepting new patients

Locations

3700 W 12th Ave
Ste 210
Hialeah, FL 33012
Phone (305) 487-7050

11760 SW 40th St
Ste 451
Miami, FL 33175
Phone (305) 227-9233

14601 SW 29th St
Ste 206
Miramar, FL 33027
Phone (954) 885-5551

11924 Forest Hill Blvd
Ste 10A411
Wellington, FL 33414

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00136
  • FHIR API: https://app.meldrx.com/api/fhir/ez_00135

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1669953535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16514 SW 19TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274466",
            "telephone_number": "786-270-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16514 SW 19TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274466",
            "telephone_number": "786-270-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "ILEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9350669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.