Individual provider Active NPI

Juan Luis Segura, ARNP

  • Acute Care Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1801109335
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9292534 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 987-2000
NPI assigned
Jul 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9292534 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

11501 N Military TRL
Palm Beach Gardens, FL 33410-6507
Phone (954) 249-7581

Other practice location 1

1150 N 35th Ave
Suite 670
Hollywood, FL 33021-5424
Phone (954) 249-7581

Other identifiers 1

IdentifierTypeStateIssuer
1801109335MedicaidFL

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
I20180815003951 FL Practitioner - Nurse Practitioner 9436408903 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9292534FLMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Practitioners, LLC CurrentSince Sep 16, 2019 Accepting new patients
Gynecologic Oncology & Urogynecology CurrentSince Apr 14, 2018 Accepting new patients
Institute for Women's Health and Body, LLC PastSince Apr 14, 2018 Accepting new patients

Locations

1995 E Oakland Park Blvd
Ste 310
Ft Lauderdale, FL 33306
Phone (866) 996-8011

1150 N 35th Ave
Ste 670
Hollywood, FL 33021
Phone (954) 265-1700

4651 Sheridan St
Ste 470
Hollywood, FL 33021
Phone (954) 986-6667

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

Organizations & group practices 3

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": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1801109335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 N MILITARY TRL",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106507",
            "telephone_number": "954-249-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-987-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 N 35th Ave",
            "address_2": "Suite 670",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215424",
            "country_code": "US",
            "telephone_number": "954-249-7581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGURA",
        "first_name": "JUAN",
        "middle_name": "LUIS",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-26",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9292534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801109335",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.