Individual provider Active NPI

Pedro Enrique Rosas Santiago

  • Psychiatric/Mental Health Nurse Practitioner
  • Sunrise, FL
National Provider Identifier
1790339489
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11003535 Issued in FL
Practice address
2822 N University Dr
Sunrise, FL 33322-2450
Phone
(754) 223-2321
Fax
(754) 216-2949
NPI assigned
Jul 31, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11003535 FL Primary
Family Nurse Practitioner 363LF0000X APRN11003535 FL

Addresses

Primary practice location

2822 N University Dr
Sunrise, FL 33322-2450

Mailing address

2822 N University Dr
Sunrise, FL 33322-2450
Phone (754) 223-2321

Other practice location 1

155 SW 6th St
Pompano Beach, FL 33060-7917
Phone (754) 223-2321

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
I20201026000947 FL Practitioner - Nurse Practitioner 1658795166 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

Practice addresses (Care Compare)

2822 N University Dr
Sunrise, FL 33322-2450
Phone (754) 223-2321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11003535FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wellness Consultants LLC Family CurrentSince Dec 14, 2020 Accepting new patients
Clinica Familiar LLC Family CurrentSince Sep 29, 2024 Accepting new patients
Rosas Mental Health Center LLC CurrentSince Jun 10, 2025 Accepting new patients
Doctor United Group Inc Past Accepting new patients

Locations

155 SW 6th St
Pompano Beach, FL 33060
Phone (754) 220-0126

2822 N University Dr
Sunrise, FL 33322
Phone (754) 223-2321

6068 S Western Ave
Oklahoma City, OK 73139
Phone (469) 996-5502

12737 E 41st St
Tulsa, OK 74146
Phone (918) 410-0041

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1790339489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 N UNIVERSITY DR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333222450",
            "telephone_number": "754-223-2321",
            "fax_number": "954-252-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 N UNIVERSITY DR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333222450",
            "telephone_number": "754-223-2321",
            "fax_number": "754-216-2949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 SW 6th St",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330607917",
            "country_code": "US",
            "telephone_number": "754-223-2321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSAS SANTIAGO",
        "first_name": "PEDRO",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-31",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11003535",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

Verify at the official NPI Registry.