Individual provider Active NPI

Grisell Villares, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1679167373
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11011660 Issued in FL
Practice address
7950 NW 2ND St
Miami, FL 33126-8017
Phone
(305) 642-5366
Fax
(305) 631-3851
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 11011660 FL Primary

Addresses

Primary practice location

7950 NW 2ND St
Miami, FL 33126-8017

Mailing address

4578 W 12TH Ave
Hialeah, FL 33012-3325
Phone (305) 828-1989

Other names 1

  • Mrs. Grisell Villares Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11011660FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1679167373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4578 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123325",
            "telephone_number": "305-828-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 NW 2ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331268017",
            "telephone_number": "305-642-5366",
            "fax_number": "305-631-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARES",
        "first_name": "GRISELL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRISELL",
            "last_name": "VILLARES",
            "prefix": "MRS.",
            "credential": "ARPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.