Integrated Primary Care & Psych Mental Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

INTEGRATED PRIMARY CARE & PSYCH MENTAL HEALTH LLC

Practice address

4300 N University Dr Ste C103
Sunrise, FL 33351-6243

Phone

(954) 478-5763

Fax

(954) 901-2713

NPI assigned

Mar 19, 2020

Last updated

Aug 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicolas Emanuel Aquino-Munoz

Title

Chief Executive Officer

Phone

(954) 667-4186

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anahi Penelope Munoz, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sunrise, FL
  • NPI 1376918631
  Medicare reassignment
• Sabrina Mautner

  • Mental Health Counselor
  • Pembroke Pines, FL
  • NPI 1992213250
  NPD

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1730715897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 N UNIVERSITY DR STE C103",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516243",
            "telephone_number": "954-478-5763",
            "fax_number": "954-901-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 N UNIVERSITY DR STE C103",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516243",
            "telephone_number": "954-478-5763",
            "fax_number": "954-901-2713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PRIMARY CARE & PSYCH MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "AQUINO-MUNOZ",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "EMANUEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "954-667-4186"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376918631",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.