Individual provider Active NPI

Jerome Dharmauir Noronha, ARNP-BC

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1720384357
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP2931082 Issued in FL
Practice address
1500 Lakeland Hills Blvd
Suite 2
Lakeland, FL 33805-3257
Phone
(863) 682-8200
NPI assigned
Jan 29, 2011
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP2931082 FL Primary
Adult Health Nurse Practitioner 363LA2200X APRN2931082 FL

Addresses

Primary practice location

1500 Lakeland Hills Blvd
Suite 2
Lakeland, FL 33805-3257

Mailing address

1500 Lakeland Hills Blvd
Suite 2
Lakeland, FL 33805-3257
Phone (863) 682-8200

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
I20110525000771 FL Practitioner - Nurse Practitioner 2567648637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

1255 Brice Blvd
Bartow, FL 33830-6735
Phone 863519790011093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Jan 1, 2023 Accepting new patients
Florida Department of Health CurrentSince Jan 1, 2023 Accepting new patients

Locations

1749 Holt Rd
Auburndale, FL 33823
Phone (863) 965-6259

1805 Hobbs Rd
Auburndale, FL 33823
Phone (863) 533-1111

1255 Brice Blvd
Bartow, FL 33830
Phone (863) 519-8233

1290 Golfview Ave
Bartow, FL 33830
Phone (863) 519-7900

1290 Golfview Ave
#4
Bartow, FL 33830

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, 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": "1296259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1720384357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD",
            "address_2": "SUITE 2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053257",
            "telephone_number": "863-682-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD",
            "address_2": "SUITE 2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053257",
            "telephone_number": "863-682-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORONHA",
        "first_name": "JEROME",
        "middle_name": "DHARMAUIR",
        "name_prefix": "Mr.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-29",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2931082",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN2931082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.