Individual provider Active NPI

Malia Keen, APRN

  • Nurse Practitioner
  • Vero Beach, FL
National Provider Identifier
1780294298
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11008370 Issued in FL
Practice address
3730 7TH Ter Ste 101
Vero Beach, FL 32960-6556
Phone
(772) 581-0528
Fax
(844) 829-3327
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11008370 FL Primary

Addresses

Primary practice location

3730 7TH Ter Ste 101
Vero Beach, FL 32960-6556

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other identifiers 1

IdentifierTypeStateIssuer
110653900MedicaidFL

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
I20200922001182 FL Practitioner - Nurse Practitioner 6608294749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3730 7TH Ter
Suite 101
Vero Beach, FL 32960-6556
Phone (772) 567-2332

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Aug 10, 2020 Accepting new patients
Florida Cancer Specialists & Research Institute, LLC Past Accepting new patients

Locations

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

3840 Broadway
Fort Myers, FL 33901
Phone (239) 275-6400

13060 US Highway 1
Ste A
Sebastian, FL 32958
Phone (772) 589-0879

3730 7th Ter
Ste 101
Vero Beach, FL 32960
Phone (772) 567-2332

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1780294298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 7TH TER STE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606556",
            "telephone_number": "772-581-0528",
            "fax_number": "844-829-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "MALIA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11008370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110653900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.