Individual provider Active NPI

Sandro Hernandez Alfonso, APRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1790444370
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11016619 Issued in FL
Practice address
8756 SW 72ND St
Miami, FL 33173-3512
Phone
(865) 987-0047
Fax
(786) 598-7005
NPI assigned
Dec 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 11016619 FL Primary

Addresses

Primary practice location

8756 SW 72ND St
Miami, FL 33173-3512

Mailing address

8756 SW 72ND St
Miami, FL 33173-3512
Phone (786) 598-7004

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
I20220107000313 FL Practitioner - Nurse Practitioner 8820489594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrum Medical Group, LLCGroup PAC ID 8527393107, 2 clinicians

Practice addresses (Care Compare)

8756 SW 72ND St
Miami, FL 33173-3512
Phone (786) 598-7004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11016619FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrum Medical Group, LLC CurrentSince Jan 3, 2022 Accepting new patients

Locations

8756 SW 72nd St
Miami, FL 33173
Phone (786) 384-1150

Organizations & group practices 1

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": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1790444370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8756 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733512",
            "telephone_number": "786-598-7004",
            "fax_number": "786-598-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8756 SW 72ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733512",
            "telephone_number": "865-987-0047",
            "fax_number": "786-598-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ ALFONSO",
        "first_name": "SANDRO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-10",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11016619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.