Individual provider Active NPI

Mayra Alejandra Diaz, APRN

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1851054233
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11015891 Issued in FL
Practice address
258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558
Phone
(407) 303-6588
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11015891 FL Primary

Addresses

Primary practice location

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558

Mailing address

258 S Chickasaw TRL Ste 203
Orlando, FL 32825-3558
Phone (407) 303-6588

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
I20220427000338 FL Practitioner - Nurse Practitioner 7719374453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015891FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Jun 6, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 6, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

258 S Chickasaw Trl
Ste 203
Orlando, FL 32825
Phone (407) 303-6588

258 S Chickasaw Trl
Ste 300
Orlando, FL 32825
Phone (407) 303-6330

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mmckoy136713@adventhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1851054233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558",
            "telephone_number": "407-303-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 S CHICKASAW TRL STE 203",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328253558",
            "telephone_number": "407-303-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "MAYRA",
        "middle_name": "ALEJANDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11015891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.