Individual provider Active NPI

Lucerna Tamames, FNP

  • Family Nurse Practitioner
  • Lutz, FL
National Provider Identifier
1679144158
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11014018 Issued in FL
Practice address
19112 Sunlake Blvd
Lutz, FL 33558-4928
Phone
(305) 910-4765
NPI assigned
Jul 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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 11014018 FL Primary

Addresses

Primary practice location

19112 Sunlake Blvd
Lutz, FL 33558-4928

Mailing address

19112 Sunlake Blvd
Lutz, FL 33558-4928
Phone (305) 910-4765

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
I20230330000005 FL Order and Referring Only - Nurse Practitioner 9638543887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11014018FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1679144158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19112 SUNLAKE BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584928",
            "telephone_number": "305-910-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19112 SUNLAKE BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584928",
            "telephone_number": "305-910-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAMES",
        "first_name": "LUCERNA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.