Individual provider Active NPI

Sujen A Gentles, LPN

  • Licensed Practical Nurse
  • Wilton Manors, FL
National Provider Identifier
1760013882
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
5217588 Issued in FL
Practice address
871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731
Phone
(305) 576-1234
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 5217588 FL Primary

Addresses

Primary practice location

871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731

Mailing address

9272 NW 49TH PL
Sunrise, FL 33351-5200
Phone (954) 274-3327

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
5217588FLMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1760013882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9272 NW 49TH PL",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515200",
            "telephone_number": "954-274-3327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 W OAKLAND PARK BLVD",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333111731",
            "telephone_number": "305-576-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTLES",
        "first_name": "SUJEN",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "5217588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.