Erisdanys Carballeda Puebla, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11012344 Issued in FL

Practice address

3710 Arcade TRL Apt 307
Lutz, FL 33548-7961

Phone

(813) 900-9544

NPI assigned

May 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Vitae Health Medical Florida PLLCGroup PAC ID 6204166762, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Vitae Health Medical Florida PLLC

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1013562024

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Mana Health Partners PA

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1437925047
  Medicare reassignment Care Compare group
• Orlando Infectious Disease Consultancy Services PL

  • Infectious Disease Physician
  • Kissimmee, FL
  • NPI 1881769685

  Multi-Specialty

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  FL

  Medicare reassignment
• Osceola Infectious Disease Consultancy Services, PLLC

  • Infectious Disease Physician
  • Kissimmee, FL
  • NPI 1528750965

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1811570328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 ARCADE TRL APT 307",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487961",
            "telephone_number": "813-900-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 ARCADE TRL APT 307",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487961",
            "telephone_number": "813-900-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBALLEDA PUEBLA",
        "first_name": "ERISDANYS",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11012344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonnathan Alberto Camacho, D.C.
• Kalyn V Cameron, APRN
• April Veronica Campbell, MSW
• Cierra Denise Cangeme
• Pavel Capote, MD
• Brinn McKayla Card, BCBA
• Yamileth Cardenas-Lamas
• Omar Cardenas, M.D.
• Sophia M Cardenas, CD
• James D Cardinale, PA-C

• Family Nurse Practitioner in Lutz, FL
• Providers in Lutz, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.