Active NPI
Alba Lucia Ceballos, APRN
- Family Nurse Practitioner
- Pembroke Pines, FL
National Provider Identifier
1861963563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN11000490
- Practice address
- 2488 N University Dr
Pembroke Pines, FL 33024-3624 - Phone
- (954) 983-9191
- NPI assigned
- Dec 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | APRN11000490 | FL | |
| Adult Medicine Physician | 207QA0505X | 11000490 | FL | |
| Family Nurse Practitioner | 363LF0000X | APRN11000490 | FL | Primary |
Addresses
Primary practice location
2488 N University Dr
Pembroke Pines, FL 33024-3624
Mailing address
2488 N University Dr
Pembroke Pines, FL 33024-3624
Phone (954) 983-9191
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
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11000490 | FL | MD | Adolescent Medicine (Family Medicine) Physician |
| 11000490 | FL | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585008000000",
"number": "1861963563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2488 N UNIVERSITY DR",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330243624",
"telephone_number": "954-983-9191",
"fax_number": "954-983-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2488 N UNIVERSITY DR",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330243624",
"telephone_number": "954-983-9191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEBALLOS",
"first_name": "ALBA",
"middle_name": "LUCIA",
"name_prefix": "Mrs.",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-07",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0000X",
"taxonomy_group": "",
"desc": "Family Medicine, Adolescent Medicine",
"state": "FL",
"license": "APRN11000490",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "FL",
"license": "11000490",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "APRN11000490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.