Individual provider Active NPI

Jorge Antonio Paulino, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1811727084
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11009980 Issued in FL
Practice address
10821 Paperbark PL
Boynton Beach, FL 33437-7533
Phone
(786) 623-9256
NPI assigned
Aug 3, 2024
Last updated
Aug 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11009980 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11009980 FL Primary

Addresses

Primary practice location

10821 Paperbark PL
Boynton Beach, FL 33437-7533

Mailing address

10821 Paperbark PL
Boynton Beach, FL 33437-7533
Phone (786) 623-9256

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
11009980FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1722643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1811727084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10821 PAPERBARK PL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334377533",
            "telephone_number": "786-623-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10821 PAPERBARK PL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334377533",
            "telephone_number": "786-623-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULINO",
        "first_name": "JORGE",
        "middle_name": "ANTONIO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-03",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11009980",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11009980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.