Jessica Marie Carrasquillo, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11005123 Issued in FL

Practice address

8200 W Sunrise Blvd BLDG C
Plantation, FL 33322-5426

Phone

(786) 246-3507

NPI assigned

Jan 29, 2020

Last updated

Jan 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1710518659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2286 SW 126TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330272639",
            "telephone_number": "786-246-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 W SUNRISE BLVD BLDG C",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333225426",
            "telephone_number": "786-246-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11005123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Plantation, FL
• Providers in Plantation, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.