Individual provider Active NPI

Sydalg Fuentes, FNP-BC

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1679133763
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06191766 Issued in FL
Practice address
11211 SW 152ND St
Miami, FL 33157-1101
Phone
(305) 255-1355
Fax
(305) 255-1355
NPI assigned
Jun 19, 2019
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 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 Practitioner 363LF0000X F06191766 FL Primary

Addresses

Primary practice location

11211 SW 152ND St
Miami, FL 33157-1101

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (786) 758-3165

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
I20220517003216 FL Practitioner - Nurse Practitioner 5597142323 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Claremedica Viking LLCGroup PAC ID 4789112301, 75 clinicians
South Dade Primary Care LLCGroup PAC ID 6002835360, 24 clinicians

Practice addresses (Care Compare)

11211 SW 152ND St
Miami, FL 33157-1101
Phone (305) 255-1355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06191766FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Dade Primary Care, LLC CurrentSince Jun 9, 2025 Accepting new patients
Ramon Leon MD LLC CurrentSince Feb 1, 2023 Accepting new patients
Claremedica Viking LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

27455 S Dixie Hwy
Unit 1
Homestead, FL 33032
Phone (305) 245-3247

600 N Homestead Blvd
Homestead, FL 33030
Phone (305) 509-6868

1000 NW 57th Ct
Ste 400
Miami, FL 33126

11211 SW 152nd St
Miami, FL 33157
Phone (305) 255-1355

9835 E Hibiscus St
Palmetto Bay, FL 33157
Phone (305) 238-8561

7000 SW 62nd Ave
Ste 210
South Miami, FL 33143
Phone (305) 661-9100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15805/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1679133763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "786-758-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331571101",
            "telephone_number": "305-255-1355",
            "fax_number": "305-255-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "SYDALG",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F06191766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.