Individual provider Active NPI

Sergio Ramon Palacios Carreno, APRN

  • Family Nurse Practitioner
  • Doral, FL
National Provider Identifier
1841000528
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11037149 Issued in FL
Practice address
8600 NW 41St St
Doral, FL 33166-6202
Phone
(305) 642-5366
NPI assigned
Jan 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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 11037149 FL Primary

Addresses

Primary practice location

8600 NW 41St St
Doral, FL 33166-6202

Mailing address

5396 W 14TH Ave
Hialeah, FL 33012-3032
Phone (786) 521-4128

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
I20250320001129 FL Practitioner - Nurse Practitioner 3779005657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11037149FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Leon Medical Centers LLC CurrentSince Jan 27, 2025 Accepting new patients

Locations

8600 NW 41st St
Doral, FL 33166
Phone (305) 642-1511

2020 W 64th St
Hialeah, FL 33016
Phone (305) 631-5924

11501 SW 40th St
Miami, FL 33165
Phone (305) 646-3716

Organizations & group practices 1

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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1841000528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5396 W 14TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123032",
            "telephone_number": "786-521-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 NW 41ST ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666202",
            "telephone_number": "305-642-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS CARRENO",
        "first_name": "SERGIO",
        "middle_name": "RAMON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11037149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.