Individual provider Active NPI

Glaiza Lanuza, ARNP

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1790295376
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9299456 Issued in FL
Practice address
4904 Beach Blvd
Orlando, FL 32803-3106
Phone
(407) 619-8069
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 9299456 FL Primary

Addresses

Primary practice location

4904 Beach Blvd
Orlando, FL 32803-3106

Mailing address

4904 Beach Blvd
Orlando, FL 32803-3106
Phone (407) 619-8069

Other identifiers 1

IdentifierTypeStateIssuer
9299456OtherFLFLORIDA BOARD OF NURSING

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
I20180918004452 FL Practitioner - Nurse Practitioner 4880945658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians

Practice addresses (Care Compare)

13941 15TH St
Dade City, FL 33525-4010
Phone (727) 861-5250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9299456FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Aug 8, 2018 Accepting new patients
Florida Department of Health CurrentSince Aug 8, 2018 Accepting new patients

Locations

13941 15th St
Dade City, FL 33525
Phone (352) 521-1450

10841 Little Rd
New Pt Richey, FL 34654
Phone (727) 861-5250

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": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790295376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 BEACH BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033106",
            "telephone_number": "407-619-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 BEACH BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033106",
            "telephone_number": "407-619-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANUZA",
        "first_name": "GLAIZA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9299456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BOARD OF NURSING",
            "identifier": "9299456",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.