Individual provider Active NPI

Edgar R Peralta-Lee, APRN

  • Family Nurse Practitioner
  • Miami Gardens, FL
National Provider Identifier
1841086881
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11038681 Issued in FL
Practice address
111 NW 183Rd St Ste 204
Miami Gardens, FL 33169-4578
Phone
(305) 655-0702
Fax
(305) 655-0845
NPI assigned
Apr 16, 2025
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 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 APRN11038681 FL Primary

Addresses

Primary practice location

111 NW 183Rd St Ste 204
Miami Gardens, FL 33169-4578

Mailing address

1412 SW 158TH Ave
Pembroke Pines, FL 33027-2368
Phone (347) 606-5911

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
I20250604000016 FL Practitioner - Nurse Practitioner 7416466180 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Depression and Mental Health Services, LLC CurrentSince Sep 3, 2025 Accepting new patients
MP Primary Care Services Family CurrentSince May 29, 2025 Accepting new patients
Donovan D Taylor MD PA PastSince Apr 20, 2025 Accepting new patients

Locations

2778 US Highway 27 S
Avon Park, FL 33825
Phone (863) 336-5888

1110 Bell Shoals Rd
Ste 101
Brandon, FL 33511
Phone (863) 358-0500

200 N John Young Pkwy
Ste 101
Kissimmee, FL 34741
Phone (407) 518-9339

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1841086881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 SW 158TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330272368",
            "telephone_number": "347-606-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NW 183RD ST STE 204",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331694578",
            "telephone_number": "305-655-0702",
            "fax_number": "305-655-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA-LEE",
        "first_name": "EDGAR",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11038681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

Verify at the official NPI Registry.