Individual provider Active NPI

Anibal Reinier Cabrera Lopez

  • Family Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1790311454
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11006635 Issued in FL
Practice address
1740 NW 167TH St
Miami Gardens, FL 33054-6661
Phone
(786) 856-8237
NPI assigned
Mar 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704420118 MI
Family Nurse Practitioner 363LF0000X APRN11006635 FL Primary

Addresses

Primary practice location

1740 NW 167TH St
Miami Gardens, FL 33054-6661

Mailing address

1740 NW 167TH St
Miami Gardens, FL 33054-6661
Phone (786) 856-8237

Other practice location 1

20263 Hoover St
Detroit, MI 48205-1033
Phone (786) 856-8237

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
I20210304000982 FL Practitioner - Nurse Practitioner 4981010618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shi Keys LLCGroup PAC ID 2163835513, 20 clinicians

Practice addresses (Care Compare)

91500 Overseas Hwy
Tavernier, FL 33070-2547
Phone (305) 434-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704420118MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aoc Healthcare Center CurrentSince Jun 1, 2022 Accepting new patients
Shi Keys LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

4801 Hollywood Blvd
Ste B
Hollywood, FL 33021
Phone (954) 927-5382

3301 Overseas Hwy
Marathon, FL 33050
Phone (305) 743-5533

91500 Overseas Hwy
Tavernier, FL 33070
Phone (305) 434-3000

20263 Hoover St
Detroit, MI 48205
Phone (786) 856-8237

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1790311454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546661",
            "telephone_number": "786-856-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330546661",
            "telephone_number": "786-856-8237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20263 Hoover St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482051033",
            "country_code": "US",
            "telephone_number": "786-856-8237",
            "fax_number": "786-685-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABRERA LOPEZ",
        "first_name": "ANIBAL",
        "middle_name": "REINIER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704420118",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.