Individual provider Active NPI

Tisdrey Torres, APRN

  • Family Nurse Practitioner
  • Deerfield Beach, FL
National Provider Identifier
1740825025
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11004359 Issued in FL
Practice address
1192 E Newport Center Dr
Deerfield Beach, FL 33442-7753
Phone
(305) 243-5302
Fax
(305) 243-9161
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 APRN11004359 FL
Family Nurse Practitioner 363LF0000X APRN11004359 FL Primary

Addresses

Primary practice location

1192 E Newport Center Dr
Deerfield Beach, FL 33442-7753

Mailing address

640 NW 78TH Ave
Pembroke Pines, FL 33024-7038
Phone (786) 431-7870

Other names 1

  • Tisdrey Roque Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tt665@georgetown.edu

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
I20200109002562 FL Practitioner - Nurse Practitioner 8022443514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11004359FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1740825025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NW 78TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330247038",
            "telephone_number": "786-431-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 E NEWPORT CENTER DR",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334427753",
            "telephone_number": "305-243-5302",
            "fax_number": "305-243-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "TISDREY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11004359",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tt665@georgetown.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "3900 Reservoir Rd NW",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200072126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TISDREY",
            "last_name": "ROQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.