Individual provider Active NPI

Steven De Jesus

  • Student in an Organized Health Care Education/Training Program
  • Ft Lauderdale, FL
National Provider Identifier
1821819913
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PSI47401 Issued in FL
Practice address
3300 S University Dr
Ft Lauderdale, FL 33328-2004
Phone
(800) 541-6682
NPI assigned
Oct 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PSI47401 FL Primary

Addresses

Primary practice location

3300 S University Dr
Ft Lauderdale, FL 33328-2004

Mailing address

Alturas de Rio Grande
Calle 10 J447
Rio Grande, PR 00745
Phone (787) 454-5604

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
PSI47401FLMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1821819913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ALTURAS DE RIO GRANDE",
            "address_2": "CALLE 10 J447",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-454-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 S UNIVERSITY DR",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333282004",
            "telephone_number": "800-541-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "STEVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PSI47401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.