Individual provider Active NPI

Stephan Dimitrjevitch, APRN PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1801711403
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11049967 Issued in FL
Practice address
9885 SW 123Rd Ter
Miami, FL 33176-4935
Phone
(786) 801-7095
NPI assigned
Aug 12, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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 APRN11049967 FL Primary

Addresses

Primary practice location

9885 SW 123Rd Ter
Miami, FL 33176-4935

Mailing address

13818 SW 152ND St # 216
Miami, FL 33177-1164
Phone (786) 801-7095

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

NPI Registry JSON

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

{
    "created_epoch": "1786492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1801711403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13818 SW 152ND ST # 216",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771164",
            "telephone_number": "786-801-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9885 SW 123RD TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331764935",
            "telephone_number": "786-801-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRJEVITCH",
        "first_name": "STEPHAN",
        "credential": "APRN PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-08-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11049967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.