Individual provider Active NPI

Fanya Tokwaulu, ARNP FNP-BC

  • Family Nurse Practitioner
  • Palmetto Bay, FL
National Provider Identifier
1801174974
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9269319 Issued in FL
Practice address
14707 S Dixie Hwy Ste 402E
Palmetto Bay, FL 33176-7960
Phone
(305) 528-3040
NPI assigned
Jul 24, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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 9269319 FL Primary

Addresses

Primary practice location

14707 S Dixie Hwy Ste 402E
Palmetto Bay, FL 33176-7960

Mailing address

14707 S Dixie Hwy Ste 402E
Palmetto Bay, FL 33176-7960
Phone (305) 528-3040

Other practice location 1

14707 S Dixie Hwy Ste 402E
Palmetto Bay, FL 33176-7960
Phone (305) 528-3040

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
I20120830000436 FL Practitioner - Nurse Practitioner 0244486165 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9269319FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Criticare Clinics Inc CurrentSince Jul 21, 2012 Accepting new patients
Pedem PLLC Past Accepting new patients

Locations

4741 S University Dr
Davie, FL 33328
Phone (954) 837-1050

14701 NW 77th Ave
Miami Lakes, FL 33014
Phone (305) 669-2833

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1801174974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14707 S DIXIE HWY STE 402E",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767960",
            "telephone_number": "305-528-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14707 S DIXIE HWY STE 402E",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767960",
            "telephone_number": "305-528-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14707 S Dixie Hwy Ste 402E",
            "address_purpose": "LOCATION",
            "city": "Palmetto Bay",
            "state": "FL",
            "postal_code": "331767960",
            "country_code": "US",
            "telephone_number": "305-528-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOKWAULU",
        "first_name": "FANYA",
        "name_prefix": "Ms.",
        "credential": "ARNP FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-24",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9269319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

Verify at the official NPI Registry.