Individual provider Active NPI

Merlande Fragelus

  • Gerontology Nurse Practitioner
  • Miami, FL
National Provider Identifier
1821717042
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11000164 Issued in FL
Practice address
770 NE 86TH St
Miami, FL 33138-3626
Phone
(305) 757-8170
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11000164 FL Primary

Addresses

Primary practice location

770 NE 86TH St
Miami, FL 33138-3626

Mailing address

2888 SW 83Rd Ave
Miramar, FL 33025-7409

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
11000164FLMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1821717042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 SW 83RD AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 NE 86TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331383626",
            "telephone_number": "305-757-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGELUS",
        "first_name": "MERLANDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11000164",
            "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 22, 2022; 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.