Individual provider Active NPI

Rose Hamideh Javaheri

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1841947488
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN11018455 Issued in FL
Practice address
110 W Underwood St
Orlando, FL 32806-1139
Phone
(407) 422-3790
Fax
(407) 425-4358
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 11018455 FL
Pediatric Nurse Practitioner 363LP0200X 11018455 FL
Adult Health Nurse Practitioner 363LA2200X APRN11018455 FL Primary

Addresses

Primary practice location

110 W Underwood St
Orlando, FL 32806-1139

Mailing address

110 W Underwood St
Orlando, FL 32806-1139
Phone (407) 422-3790

Other practice location 1

8755 The Esplanade Apt 116
Orlando, FL 32836-7726
Phone (407) 620-1016

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11018455FLMDAdult Health Nurse Practitioner
11018455FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1841947488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061139",
            "telephone_number": "407-422-3790",
            "fax_number": "407-425-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W UNDERWOOD ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061139",
            "telephone_number": "407-422-3790",
            "fax_number": "407-425-4358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8755 The Esplanade Apt 116",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328367726",
            "country_code": "US",
            "telephone_number": "407-620-1016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVAHERI",
        "first_name": "ROSE",
        "middle_name": "HAMIDEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11018455",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11018455",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN11018455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.