Individual provider Active NPI

Maria Mitsotakis, APRN

  • Family Nurse Practitioner
  • Palm Harbor, FL
National Provider Identifier
1780439232
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11032262 Issued in FL
Practice address
4488 Grand Preserve PL
Palm Harbor, FL 34684-1047
Phone
(917) 299-3064
NPI assigned
Apr 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11032262 FL Primary

Addresses

Primary practice location

4488 Grand Preserve PL
Palm Harbor, FL 34684-1047

Mailing address

4488 Grand Preserve PL
Palm Harbor, FL 34684-1047
Phone (917) 299-3064

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
I20240806000016 FL Practitioner - Nurse Practitioner 1557808797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Arizona College of Medicine - Phoenix, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 W Jefferson St
Louisville, KY 40202-2881

6329 State Rd
Suite 54
New Port Richey, FL 34653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11032262FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Walk in Clinic,PLLC CurrentSince Jul 29, 2024 Accepting new patients
Guidewell Sanitas I, LLC CurrentSince Sep 1, 2025 Accepting new patients
Gulf View Medical & Urgent Care Inc Current Accepting new patients
Eman FNP PLLC Family PastSince Apr 21, 2024 Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

9400 Atlantic Blvd
Ste 11
Jacksonville, FL 32225
Phone (904) 775-3138

6329 State Road 54
New Prt Rchy, FL 34653
Phone (727) 844-5555

180 SW 84th Ave
Plantation, FL 33324
Phone (954) 271-2855

11123 County Line Rd
Spring Hill, FL 34609
Phone (352) 666-5555

Organizations & group practices 4

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": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1780439232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 GRAND PRESERVE PL",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841047",
            "telephone_number": "917-299-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 GRAND PRESERVE PL",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841047",
            "telephone_number": "917-299-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSOTAKIS",
        "first_name": "MARIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11032262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.