Individual provider Active NPI

Yanet Miranda

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1821567546
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000242 Issued in FL
Practice address
9501 Anderson Rd
Tampa, FL 33634-1252
Phone
(813) 413-7333
Fax
(813) 563-4530
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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 11000242 FL Primary

Addresses

Primary practice location

9501 Anderson Rd
Tampa, FL 33634-1252

Mailing address

9501 Anderson Rd
Tampa, FL 33634-1252
Phone (813) 413-7333

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
I20190913001930 FL Practitioner - Nurse Practitioner 8123357233 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11000242FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Apr 1, 2022 Accepting new patients
Dedicated Senior Medical Center of Florida, LLC CurrentSince Apr 1, 2022 Accepting new patients
Perez Eye Center P L PastSince Jan 17, 2012 Accepting new patients
Perez and Perez MDS PA Past Accepting new patients

Locations

4715 S Florida Ave
Lakeland, FL 33813
Phone (863) 209-7003

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

9501 Anderson Rd
Tampa, FL 33634
Phone (813) 413-7333

3128 E Hillsborough Ave
Tampa, FL 33610
Phone (813) 579-1767

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1821567546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 ANDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341252",
            "telephone_number": "813-413-7333",
            "fax_number": "813-563-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ANDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341252",
            "telephone_number": "813-413-7333",
            "fax_number": "813-563-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "YANET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.