Individual provider Active NPI

Maria Fernanda Antunez, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coral Gables, FL
National Provider Identifier
1770240483
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11022295 Issued in FL
Practice address
917 Tangier St
Coral Gables, FL 33134-2482
Phone
(786) 487-3548
NPI assigned
Nov 17, 2021
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9472531 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11022295 FL Primary

Addresses

Primary practice location

917 Tangier St
Coral Gables, FL 33134-2482

Mailing address

917 Tangier St
Coral Gables, FL 33134-2482
Phone (786) 487-3548

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
I20240507002317 FL Practitioner - Nurse Practitioner 3375984479 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9472531FLMDRegistered Nurse
11022295FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Personal Management LLC CurrentSince Apr 26, 2024 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince May 14, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

13155 SW 134th St
Ste 202
Miami, FL 33186
Phone (786) 471-1929

22133 S Dixie Hwy
Miami, FL 33170
Phone (786) 504-3119

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1770240483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 TANGIER ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342482",
            "telephone_number": "786-487-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 TANGIER ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331342482",
            "telephone_number": "786-487-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNEZ",
        "first_name": "MARIA",
        "middle_name": "FERNANDA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9472531",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11022295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.