Individual provider Active NPI

Roberto Arturo Pohlenz-McBeath

  • Psychiatric/Mental Health Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1790445310
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11017083 Issued in FL
Practice address
3503 Forest Park Dr
Kissimmee, FL 34746-2803
Phone
(407) 607-4371
NPI assigned
Dec 22, 2021
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11017083 FL Primary

Addresses

Primary practice location

3503 Forest Park Dr
Kissimmee, FL 34746-2803

Mailing address

3503 Forest Park Dr
Kissimmee, FL 34746-2803
Phone (407) 607-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11017083FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1790445310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 FOREST PARK DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462803",
            "telephone_number": "407-607-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3503 FOREST PARK DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462803",
            "telephone_number": "407-607-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLENZ-MCBEATH",
        "first_name": "ROBERTO",
        "middle_name": "ARTURO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11017083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.